Organization
RAY WILLIAMS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND THOMAS WILLIAMS LMFT (PRESIDENT, OWNER)
(952) 314-9556
Entity
Organization
Contact information
Practice address
6542 REGENCY LN STE 101, EDEN PRAIRIE, MN 55344-7847
(952) 314-9556
Mailing address
6542 REGENCY LN STE 101, EDEN PRAIRIE, MN 55344-7847
(952) 314-9556
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004344241
BLUE CROSS BLUE SHIELD NUMBER
MN
01
—
1619276052
INDIVIDUAL NPI NUMBER
MN
Enumeration date
12/22/2020
Last updated
12/22/2020
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