Provider Demographics
NPI:1437481017
Name:RAY, JEFF P (LMHC, CAP, CSAT)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:P
Last Name:RAY
Suffix:
Gender:M
Credentials:LMHC, CAP, CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3137
Mailing Address - Country:US
Mailing Address - Phone:561-707-6591
Mailing Address - Fax:888-820-1824
Practice Address - Street 1:1860 OLD OKEECHOBEE RD
Practice Address - Street 2:SUITE #300
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-5253
Practice Address - Country:US
Practice Address - Phone:561-707-6591
Practice Address - Fax:888-820-1824
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1626101YA0400X
FL9078101YM0800X
FL2008C-0623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional