Provider Demographics
NPI:1265458319
Name:RAY, LINDA D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:D
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 1:801 W MARCY DR APT 18
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-6507
Mailing Address - Country:US
Mailing Address - Phone:432-264-0601
Mailing Address - Fax:
Practice Address - Street 1:801 W MARCY DR APT 18
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-6507
Practice Address - Country:US
Practice Address - Phone:432-264-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL64241041C0700X
TX412571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6424OtherLCSW
TX41257OtherLCSW