Individual provider Active NPI

Connie Kay Ray, LCSW, MHCL, MFTL

  • Clinical Social Worker
  • Connersville, IN
National Provider Identifier
1902857550
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34000646A Issued in IN
Practice address
707 W 3Rd St
Connersville, IN 47331-1577
Phone
(765) 827-1164
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 34000646A IN Primary

Addresses

Primary practice location

707 W 3Rd St
Connersville, IN 47331-1577

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050526000931 IN Practitioner - Clinical Social Worker 6002858255 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp CurrentSince Apr 2, 2018 Accepting new patients
Meridian Health Services Corp. CurrentSince Apr 2, 2018 Accepting new patients
Meridian Health Services Corp Past Accepting new patients

Locations

707 W 3rd St
Connersville, IN 47331
Phone (765) 827-1164

240 N Tillotson Ave
Muncie, IN 47304

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

Interoperability endpoints

  • Direct secure messaging: connie.ray.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1902857550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W 3RD ST",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311577",
            "telephone_number": "765-827-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "CONNIE",
        "middle_name": "KAY",
        "credential": "LCSW, MHCL, MFTL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000646A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, IN

Sources for this page

Verify at the official NPI Registry.