Provider Demographics
NPI:1972734531
Name:RAY, WENDY SUSAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:SUSAN
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:AUBURN HALL
Mailing Address - Street 2:60 PINELAND DR. SUITE 311
Mailing Address - City:NEW GLOUCESTER
Mailing Address - State:ME
Mailing Address - Zip Code:04260
Mailing Address - Country:US
Mailing Address - Phone:207-274-0395
Mailing Address - Fax:207-833-3219
Practice Address - Street 1:AUBURN HALL
Practice Address - Street 2:60 PINELAND DR. SUITE 311
Practice Address - City:NEW GLOUCESTER
Practice Address - State:ME
Practice Address - Zip Code:04260
Practice Address - Country:US
Practice Address - Phone:207-926-8258
Practice Address - Fax:207-833-3219
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC129301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical