Provider Demographics
NPI:1386166130
Name:RAY, HAILEY (MA, NCC, LPC-S)
Entity type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:MA, NCC, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2034 82ND ST UNIT 103
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2395
Mailing Address - Country:US
Mailing Address - Phone:806-831-5529
Mailing Address - Fax:806-828-0015
Practice Address - Street 1:2034 82ND ST UNIT 103
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2395
Practice Address - Country:US
Practice Address - Phone:806-831-5529
Practice Address - Fax:806-828-0015
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69003101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1386166130OtherNPI1
TX1770023582OtherNPI2