Provider Demographics
NPI:1053167502
Name:DINGESS, LARAYA (BS)
Entity type:Individual
Prefix:
First Name:LARAYA
Middle Name:
Last Name:DINGESS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:LARAYA
Other - Middle Name:
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:83 SHIRLEY MOORE LN
Mailing Address - Street 2:
Mailing Address - City:TOMAHAWK
Mailing Address - State:KY
Mailing Address - Zip Code:41262-8001
Mailing Address - Country:US
Mailing Address - Phone:304-784-1308
Mailing Address - Fax:
Practice Address - Street 1:20824 ROUTE 52
Practice Address - Street 2:
Practice Address - City:FORT GAY
Practice Address - State:WV
Practice Address - Zip Code:25514-7074
Practice Address - Country:US
Practice Address - Phone:304-648-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor