Provider Demographics
NPI:1679017834
Name:JORAY, BRUCE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:JORAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50550 LITTLE JOHN LN
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-7527
Mailing Address - Country:US
Mailing Address - Phone:317-900-6777
Mailing Address - Fax:
Practice Address - Street 1:50550 LITTLE JOHN LN
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-7527
Practice Address - Country:US
Practice Address - Phone:317-900-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005639A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical