Provider Demographics
NPI:1760508170
Name:RAYL, JESSIE L (MA, LPC)
Entity Type:Individual
Prefix:MISS
First Name:JESSIE
Middle Name:L
Last Name:RAYL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-1753
Mailing Address - Country:US
Mailing Address - Phone:304-262-8020
Mailing Address - Fax:304-262-8099
Practice Address - Street 1:604 WILSON ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-1753
Practice Address - Country:US
Practice Address - Phone:304-262-8020
Practice Address - Fax:304-262-8099
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1375101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health