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General NPI Number Information
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NPI Number | 1144377078
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Entity Type | Organization
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Legal Business Name | GREY COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 933 RUSSELL RD SUITE 93
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City | COLUMBIA
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State | KY
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Zip | 42728-1054
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Country | US
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Telephone | 280-384-1736
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Fax | 270-384-1734
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Provider Business Mailing Address
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Address Line | 933 RUSSELL RD SUITE 93
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City | COLUMBIA
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State | KY
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Zip | 42728-1054
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Country | US
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Telephone | 280-384-1736
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Fax | 270-384-1734
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Authorized Official
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Title or Position | ART THERAPIST
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Name | MRS. SUZY GREY
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Credential | ATR-BC, CPAT
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Telephone | 270-384-1736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | KY-CPAT-0052
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License Number State | KY
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