Provider Demographics
NPI:1639672041
Name:RAY, ARLIE A JR (LPCC)
Entity Type:Individual
Prefix:MR
First Name:ARLIE
Middle Name:A
Last Name:RAY
Suffix:JR
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 KIMBERLY CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-6443
Mailing Address - Country:US
Mailing Address - Phone:937-207-1153
Mailing Address - Fax:937-502-1334
Practice Address - Street 1:363 S BURNETT RD STE 2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-2628
Practice Address - Country:US
Practice Address - Phone:937-502-1333
Practice Address - Fax:937-502-1334
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2202760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health