Healthcare Provider Details

I. General information

NPI: 1538095971
Provider Name (Legal Business Name): ANNA GRAY-LEWIS P-LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 STONE CREEK BLVD STE 100
FLOWOOD MS
39232-8207
US

IV. Provider business mailing address

120 STONE CREEK BLVD STE 100
FLOWOOD MS
39232-8207
US

V. Phone/Fax

Practice location:
  • Phone: 601-933-1136
  • Fax:
Mailing address:
  • Phone: 601-933-1136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP-1215
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: