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General NPI Number Information
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NPI Number | 1346453701
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Entity Type | Individual
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Provider Name | THOMAS W. GRAY PH.D., LICSW, LCSW-C
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5028 WISCONSIN AVE-NW SUITE 400
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City | WASHINGTON
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State | DC
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Zip | 20016
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Country | US
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Telephone | 202-537-9351
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Fax |
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Provider Business Mailing Address
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Address Line | 155 FINALE TER
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City | SILVER SPRING
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State | MD
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Zip | 20901-5059
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Country | US
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Telephone | 202-537-9351
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC3000894
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License Number State | DC
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