Provider Demographics
NPI:1114032844
Name:RAY, LAUREN JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JANE
Last Name:RAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 759194
Mailing Address - Street 2:FAMILY PRESERVATION SERVICES
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-9194
Mailing Address - Country:US
Mailing Address - Phone:540-710-6085
Mailing Address - Fax:540-710-6447
Practice Address - Street 1:1316 PATTON AVE
Practice Address - Street 2:FAMILY PRESERVATION SERVICES
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2666
Practice Address - Country:US
Practice Address - Phone:828-225-3100
Practice Address - Fax:828-225-3604
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0053631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106442Medicaid
NC6106442Medicaid