Provider Demographics
NPI:1679541593
Name:POWERS, RAY A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:A
Last Name:POWERS
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 1:132 POPLAR GROVE CONNECTOR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5915
Mailing Address - Country:US
Mailing Address - Phone:828-264-8759
Mailing Address - Fax:828-262-5687
Practice Address - Street 1:132 POPLAR GROVE CONNECTOR
Practice Address - Street 2:SUITE B
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5915
Practice Address - Country:US
Practice Address - Phone:828-264-8759
Practice Address - Fax:828-262-5687
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0007521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2063646OtherCIGNA BEHAVIORAL HEALTH
NC68909OtherBCBS OF NC
NC95227OtherMEDCOST
NC6003625Medicaid
NCN/AOtherCBHA
NC103883OtherUNITED BEHAVIORAL HEALTH
NC2863070Medicare ID - Type UnspecifiedPROVIDER ID #
NC2339728Medicare PIN