Active NPI
Adam Richard Ray, MA
- Mental Health Counselor
- Orlando, FL
National Provider Identifier
1750916847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 18407
- Practice address
- 6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593 - Phone
- (407) 850-8369
- NPI assigned
- Mar 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 18407 | FL | Primary |
Addresses
Primary practice location
6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593
Mailing address
410 Fontana Cir Apt 303
Oviedo, FL 32765-5536
Phone (407) 443-6529
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 15, 2024 through Jul 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18407 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583712000000",
"number": "1750916847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 FONTANA CIR APT 303",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327655536",
"telephone_number": "407-443-6529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6900 TAVISTOCK LAKES BLVD STE 400",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328277593",
"telephone_number": "407-850-8369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "ADAM",
"middle_name": "RICHARD",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-09",
"last_updated": "2020-03-09",
"certification_date": "2020-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "18407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.