Individual provider Active NPI

Michelle Dawn Ray, LCSW

  • Clinical Social Worker
  • Copperas Cove, TX
National Provider Identifier
1770853335
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62096 Issued in TX
Practice address
806 E Avenue D Ste F
Copperas Cove, TX 76522-2231
Phone
(254) 547-6415
Fax
(254) 547-2030
NPI assigned
Jan 12, 2012
Last updated
Mar 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 62096 TX Primary

Addresses

Primary practice location

806 E Avenue D Ste F
Copperas Cove, TX 76522-2231

Mailing address

806 E Avenue D Ste F
Copperas Cove, TX 76522-2231
Phone (254) 547-6415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62096TXMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1770853335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 E AVENUE D STE F",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765222231",
            "telephone_number": "254-547-6415",
            "fax_number": "254-547-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 E AVENUE D STE F",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765222231",
            "telephone_number": "254-547-6415",
            "fax_number": "254-547-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Copperas Cove, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.