Healthcare Provider Details

I. General information

NPI: 1639651938
Provider Name (Legal Business Name): LIVING IN THE GREY COUNSELING AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 PASEO REYES DR
ST AUGUSTINE FL
32095-8462
US

IV. Provider business mailing address

264 PASEO REYES DR
SAINT AUGUSTINE FL
32095-8462
US

V. Phone/Fax

Practice location:
  • Phone: 904-654-8338
  • Fax: 904-647-1128
Mailing address:
  • Phone: 904-654-8338
  • Fax: 904-647-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: REBECCA MCQUAIG
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential:
Phone: 904-654-8338