Provider Demographics
NPI:1720595291
Name:AMY RAY LLC
Entity Type:Organization
Organization Name:AMY RAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-461-8060
Mailing Address - Street 1:2501 STONECREEK TRL
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-8012
Mailing Address - Country:US
Mailing Address - Phone:204-527-5273
Mailing Address - Fax:
Practice Address - Street 1:5520 HIGHWAY 280 STE 4
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2308
Practice Address - Country:US
Practice Address - Phone:205-461-8060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2611251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health