Healthcare Provider Details

I. General information

NPI: 1407331168
Provider Name (Legal Business Name): ERIK GRAY LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 ALSUN DR
HOLLIS NH
03049-6211
US

IV. Provider business mailing address

38 ALSUN DR
HOLLIS NH
03049-6211
US

V. Phone/Fax

Practice location:
  • Phone: 28-558-4316
  • Fax:
Mailing address:
  • Phone: 802-558-4316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number275
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: