Individual
MRS. CONNIE M RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
123 E AVENUE C STE B, HEAVENER, OK 74937-2603
(918) 658-4016
(866) 318-8057
Mailing address
123 E AVENUE C, HEAVENER, OK 74937-2603
(918) 658-4016
(866) 318-8057
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
1302
OK
101YM0800X
Mental Health Counselor
6213
OK
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154608164
—
OK
Enumeration date
11/05/2011
Last updated
04/15/2026
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