Provider Demographics
NPI:1568110310
Name:RAY OF LIGHT PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:RAY OF LIGHT PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-969-9325
Mailing Address - Street 1:PO BOX 10304
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20914-0304
Mailing Address - Country:US
Mailing Address - Phone:301-969-9325
Mailing Address - Fax:
Practice Address - Street 1:7910 WOODMONT AVE STE 908
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-7049
Practice Address - Country:US
Practice Address - Phone:301-969-9325
Practice Address - Fax:301-238-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty