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MR. SHELWILBED O. WRAY NCC, CAS, LCMHC-S
NPI 1174621528
Counselor - Mental Health in Southern Pines, NC

Active since September 20, 2006PECOS EnrolledAccepts Medicare Assignment
780 NW BROAD ST STE 210, SOUTHERN PINES, NC 28387(910) 725-2074(910) 725-2084 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mr. Shelwilbed O. Wray Ncc, Cas, Lcmhc-s NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SHELWILBED O. WRAY NCC, CAS, LCMHC-S (NPI 1174621528) is an individual mental health provider in Southern Pines, North Carolina, licensed in North Carolina (S7538) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1174621528
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. SHELWILBED O. WRAYCredential: NCC, CAS, LCMHC-S
Location Address780 NW BROAD ST STE 210Southern Pines, NC 28387-4102
Mailing Address780 Nw Broad St Ste 210Southern Pines, NC 28387-4102 · (910) 725-2074 · Fax (910) 725-2084
Phone(910) 725-2074
Fax(910) 725-2084
Sole ProprietorYes
Medical School CMSOtherGraduated 1991
Enumeration DateSeptember 20, 2006
Last NPPES UpdateJuly 24, 2024
NPPES CertifiedJuly 24, 2024
✔ NPI 1174621528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · S7538
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 1945 (NC)
780 NW BROAD ST STE 210, Southern Pines, NC 28387
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Shelwilbed O. Wray Ncc, Cas, Lcmhc-s is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022259852
PECOS Enrollment IDI20251226000146
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shelwilbed Wray reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kardia Counseling & Consulting Pll
4.3 mi
Professional
325 PAGE RD BLDG 3
Pinehurst, NC 28370
  • Reassigned Medicare billing, North Carolina enrollment
NPI 1124579867 (910) 295-0500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelwilbed Wray's NPI number?

The NPI number for Shelwilbed Wray is 1174621528. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Shelwilbed Wray located?

Shelwilbed Wray practices at 780 NW Broad St Ste 210, Southern Pines, NC 28387. The listed phone number is (910) 725-2074.

What is Shelwilbed Wray's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Shelwilbed Wray enrolled in Medicare?

Yes. Shelwilbed Wray is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Shelwilbed Wray's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shelwilbed Wray reassigns Medicare benefits to Kardia Counseling & Consulting Pll (Pinehurst, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shelwilbed Wray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shelwilbed Wray was last updated on July 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.