Provider Demographics
NPI:1609100239
Name:RAY, LINDA SUSAN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA SUSAN
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 S BERRY RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6303
Mailing Address - Country:US
Mailing Address - Phone:405-596-1089
Mailing Address - Fax:405-329-8815
Practice Address - Street 1:510 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5106
Practice Address - Country:US
Practice Address - Phone:405-329-7923
Practice Address - Fax:405-329-8815
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1668101YP2500X
OK213336101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool