Provider Demographics
NPI:1376280438
Name:BRAY, RAYMOND PAUL (LPC)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:PAUL
Last Name:BRAY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7870 QUERIDA LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-3151
Mailing Address - Country:US
Mailing Address - Phone:972-342-6474
Mailing Address - Fax:
Practice Address - Street 1:5300 TOWN AND COUNTRY BLVD # 240
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6894
Practice Address - Country:US
Practice Address - Phone:972-489-9995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14314101YA0400X
TX84561101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)