Healthcare Provider Details

I. General information

NPI: 1336081090
Provider Name (Legal Business Name): GINA ANN RAY/GINA RAY COU RAY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7173 S HAVANA ST STE 100-34
CENTENNIAL CO
80112-3891
US

IV. Provider business mailing address

2450 ROBIN SONG CT
CASTLE ROCK CO
80109-4734
US

V. Phone/Fax

Practice location:
  • Phone: 303-305-9773
  • Fax: 303-795-6112
Mailing address:
  • Phone: 303-305-9773
  • Fax: 303-795-6112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0019526
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: