Provider Demographics
NPI:1376934117
Name:MARY C. RAY
Entity Type:Organization
Organization Name:MARY C. RAY
Other - Org Name:RAY CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,ACSW, SEP
Authorized Official - Phone:703-683-0920
Mailing Address - Street 1:400 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3114
Mailing Address - Country:US
Mailing Address - Phone:703-683-0920
Mailing Address - Fax:
Practice Address - Street 1:201B S ROYAL ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3329
Practice Address - Country:US
Practice Address - Phone:703-683-0920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904001621261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904001621OtherVA BOARD OF SOCIAL WORK