Healthcare Provider Details

I. General information

NPI: 1447762406
Provider Name (Legal Business Name): DARIAN GRAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1077 13TH ST SE
HICKORY NC
28602-4165
US

IV. Provider business mailing address

3221 5TH STREET CT NE
HICKORY NC
28601-9338
US

V. Phone/Fax

Practice location:
  • Phone: 704-305-7915
  • Fax:
Mailing address:
  • Phone: 952-412-0238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number20520A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: