=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154036986
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EDITH RAY LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2023
-----------------------------------------------------
Last Update Date | 12/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 109 E SAINT PETER ST
-----------------------------------------------------
City | CARENCRO
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70520-4008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-692-2860
-----------------------------------------------------
Fax | 800-370-1055
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 238 BLUE RIDGE DR
-----------------------------------------------------
City | CARENCRO
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70520-5347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-654-8786
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 9393
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------