Provider Demographics
NPI:1699955633
Name:RAY, LINDELL (LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDELL
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22110 JAMAICA AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-2037
Mailing Address - Country:US
Mailing Address - Phone:718-740-3310
Mailing Address - Fax:718-740-2605
Practice Address - Street 1:22110 JAMAICA AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-2037
Practice Address - Country:US
Practice Address - Phone:718-740-3310
Practice Address - Fax:718-740-2605
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR017123-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical