Active NPI
Laray Imani Price, PH.D. - PSYCHOLOGIST
- Psychologist
- Gambrills, MD
National Provider Identifier
1942384185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 05442
- Practice address
- 331 Gambrills Rd Ste 4B
Gambrills, MD 21054-1141 - Phone
- (443) 569-8882
- Fax
- (410) 697-3623
- NPI assigned
- Oct 24, 2006
- Last updated
- Nov 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Psychologist | 103T00000X | PSY1001307 | DC | |
| Psychologist | 103T00000X | 05442 | MD | Primary |
| Clinical Psychologist | 103TC0700X | 05442 | MD | |
| Clinical Social Worker | 1041C0700X | |||
| Pediatric Occupational Therapist | 225XP0200X | |||
| Mental Health Occupational Therapist | 225XM0800X |
Addresses
Primary practice location
331 Gambrills Rd Ste 4B
Gambrills, MD 21054-1141
Mailing address
331 Gambrills Rd Ste 4B
Gambrills, MD 21054-1141
Phone (443) 569-8882
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07944490 | Medicaid | MD |
Other names 1
- Dr. Laray Imani Price-Abdelrazzaq
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@womeninnerfitness.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1001307 | DC | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Women's Innerfitness & Wellness Center | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Crofton, MD
- NPI 1225424005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1942384185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 GAMBRILLS RD STE 4B",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "210541141",
"telephone_number": "443-569-8882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 GAMBRILLS RD STE 4B",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "210541141",
"telephone_number": "443-569-8882",
"fax_number": "410-697-3623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRICE",
"first_name": "LARAY",
"middle_name": "IMANI",
"name_prefix": "Dr.",
"credential": "PH.D. - PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "DC",
"license": "PSY1001307",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "05442",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05442",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07944490",
"state": "MD"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@womeninnerfitness.com",
"affiliation": "N",
"address_1": "331 Gambrills Rd Ste 4B",
"city": "Gambrills",
"state": "MD",
"country_code": "US",
"postal_code": "210541141",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LARAY",
"last_name": "PRICE-ABDELRAZZAQ",
"middle_name": "IMANI",
"prefix": "DR.",
"credential": "PH.D. - PSYCHOLOGIST",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gambrills, MD
- Erin Pfenninger
- Poorna Phaltankar, DMD
- PM Pediatrics of Maryland LLC
- Podiatry Associates, P.a.
- Podiatry Group, P.a.
- Shamir Price, DPT
- Privia Medical Group, LLC
- Professional Sportscare & Rehab, LLC (Pivot Physical Therapy of Metro DC)
- Professional Sportscare, LLC (Pivot Physical Therapy of Maryland/Greater Baltimore)
- Professional Sportscare, LLC (Pivot Physical Therapy of Maryland/Greater Baltimore)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.