MR. KELLY S. WRAY (LADC CANDIDATE) – Addiction (Substance Use Disorder) Counselor, NPI 1013291525
Addiction (Substance Use Disorder) Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,199 MENTAL HEALTH COUNSELOR in OK
Provider Addresses for MR. KELLY S. WRAY (LADC CANDIDATE)
2029 Gordon Cooper Dr
Shawnee, OK 748019005
Phone: (405) 878-5850
Type: Location
15702 E State Highway 9
Norman, OK 730269028
Phone: (405) 447-0300
Type: Location
2530 S COMMERCE ST
ARDMORE, OK 734015519
Phone: (580) 223-5636
Type: Mailing
15951 LITTLE AXE DR
NORMAN, OK 730269088
Phone: (405) 447-0300
Type: Mailing
804 W CHOCTAW AVE
CHICKASHA, OK 730182310
Phone: (405) 424-7711
Type: Location
1829 W PARKVIEW AVE
DUNCAN, OK 735331711
Phone: (580) 370-5617
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-12-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251218001189 | I | Mental Health Counselor | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74801)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | OK | |
| Nurse Practitioner | OK | |
| Family Practice | OK | |
| P O D I A T R Y | OK | |
| Family Practice | OK | |
| Physical Therapist In Private Practice | OK | |
| Clinical Psychologist | NM | |
| Physician Assistant | OK | |
| Critical Care (Intensivists), Pulmonary Disease | DC | |
| Family Practice | OK |
Reviews
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