| Gypsy Ray Lcsw Llc | |
|
118 E 7th St Ste 2d Anaconda MT 59711-2913 | |
| (406) 880-0977 | |
| Not Available |
| Full Name | Gypsy Ray Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 118 E 7th St Ste 2d, Anaconda, Montana |
| Authorized Official Name and Position | Gypsy S Ray (OWNER) |
| Authorized Official Contact | 4068800977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gypsy Ray Lcsw Llc 88 Lakeshore Dr Anaconda MT 59711-9093 Ph: (406) 880-0977 | Gypsy Ray Lcsw Llc 118 E 7th St Ste 2d Anaconda MT 59711-2913 Ph: (406) 880-0977 |
| NPI Number | 1841753522 |
|---|---|
| Provider Enumeration Date | 04/10/2019 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 6709111701 |
|---|---|
| Medicare Enrollment ID | O20190712002490 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841753522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gypsy S Ray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215210851 PECOS PAC ID: 0244565240 Enrollment ID: I20190712002594 |
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