Healthcare Provider Details

I. General information

NPI: 1477583094
Provider Name (Legal Business Name): JEFFREY L GRAY LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MULL AVE
AKRON OH
44313-7597
US

IV. Provider business mailing address

900 MULL AVE
AKRON OH
44313-7597
US

V. Phone/Fax

Practice location:
  • Phone: 330-867-5603
  • Fax: 330-873-3439
Mailing address:
  • Phone: 330-867-5603
  • Fax: 330-873-3439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2404619
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1196
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: