Active NPI
Susan Ray, BCBA
- Counselor
- Tumwater, WA
National Provider Identifier
1962884510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 816 Fenway LN SW
Tumwater, WA 98512-4604 - Phone
- (360) 915-2073
- Fax
- (360) 915-2073
- NPI assigned
- Jun 19, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BA60773639 | WA | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
816 Fenway LN SW
Tumwater, WA 98512-4604
Mailing address
816 Fenway LN SW
Tumwater, WA 98512-4604
Phone (360) 915-2073
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BA60773639 | WA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1962884510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "816 FENWAY LN SW",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985124604",
"telephone_number": "360-915-2073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 FENWAY LN SW",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985124604",
"telephone_number": "360-915-2073",
"fax_number": "360-915-2073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "SUSAN",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-19",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "BA60773639",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.