Provider Demographics
NPI:1851450704
Name:RAY, WILLIAM J (PHD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:RAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:314 MOORE BLDG
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:16802-3103
Mailing Address - Country:US
Mailing Address - Phone:814-865-2191
Mailing Address - Fax:814-863-1331
Practice Address - Street 1:314 MOORE BUILDING
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802
Practice Address - Country:US
Practice Address - Phone:814-865-2191
Practice Address - Fax:814-863-1331
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPS002071KL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1997352OtherHIGHMARK BLUE SHIELD
PA1000740OtherCOMMUNITY CARE BEHAVIORAL HEALTH
PA2057186OtherCIGNA BEHAVIORAL HEALTH
PAA334449BOtherEMPIRE BLUE CROSS BLUE SHIELD
PA2057186OtherCIGNA BEHAVIORAL HEALTH