Provider Demographics
NPI:1275265746
Name:RAYC COUNSELING SERVICE LLC
Entity Type:Organization
Organization Name:RAYC COUNSELING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:ALC, MS
Authorized Official - Phone:334-313-2190
Mailing Address - Street 1:1332 KAREN VALLEY PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3246
Mailing Address - Country:US
Mailing Address - Phone:334-313-2190
Mailing Address - Fax:
Practice Address - Street 1:2740 CENTRAL PKWY STE 10
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3243
Practice Address - Country:US
Practice Address - Phone:334-231-6463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health