| Todd Ray, Lcsw, Pllc | |
|
6000 W Genesee St Ste 400 Camillus NY 13031-1277 | |
| (315) 400-0448 | |
| Not Available |
| Full Name | Todd Ray, Lcsw, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6000 W Genesee St Ste 400, Camillus, New York |
| Authorized Official Name and Position | Todd Michael Ray (OWNER) |
| Authorized Official Contact | 3154005606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Todd Ray, Lcsw, Pllc 6000 W Genesee St Ste 400 Camillus NY 13031-1277 Ph: (315) 400-0448 | Todd Ray, Lcsw, Pllc 6000 W Genesee St Ste 400 Camillus NY 13031-1277 Ph: (315) 400-0448 |
| NPI Number | 1346867603 |
|---|---|
| Provider Enumeration Date | 07/02/2020 |
| Last Update Date | 07/02/2020 |
| Certification Date | 07/02/2020 |
| Medicare PECOS PAC ID | 0042638165 |
|---|---|
| Medicare Enrollment ID | O20200922000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346867603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Todd Ray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487084976 PECOS PAC ID: 0840553293 Enrollment ID: I20180417001576 |
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