Provider Demographics
NPI:1871801753
Name:RAY, CAROLYN ELISABETH (CAROLYN RAY, LCSW)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ELISABETH
Last Name:RAY
Suffix:
Gender:F
Credentials:CAROLYN RAY, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4017 FAIRMONT CT
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2753
Mailing Address - Country:US
Mailing Address - Phone:817-996-4599
Mailing Address - Fax:877-226-9863
Practice Address - Street 1:7137 COLLEYVILLE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6240
Practice Address - Country:US
Practice Address - Phone:817-996-4599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker