MEDICARE: DENISE M WRAY MS LPCS MAC SAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-24577	AZ

General Provider Information

NPI Number	:	1982090429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE M WRAY MS LPCS MAC SAP

Provider Business Mailing Address
First Line	:	2345 E. MAIN ST. #109
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213
Country	:	US
Telephone Number	:	907-351-8249
Fax Number	:	806-435-3065

Provider Business Practice Location Address
First Line	:	1821 KODIAK ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-2736
Country	:	US
Telephone Number	:	907-351-8249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2015
Last Update Date	:	03/06/2026

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