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General NPI Number Information
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NPI Number | 1396200796
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Entity Type | Individual
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Provider Name | WHITNEY S GRAY
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Gender | Female
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Dates
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Enumeration Date | 02/10/2019
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Last Update Date | 11/23/2025
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Provider Practice Location Address
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Address Line | 210 W 15TH ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-2036
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Country | US
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Telephone | 803-290-6529
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Fax |
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Provider Business Mailing Address
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Address Line | 635 HIDDEN VALLEY DR
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City | CLARKSVILLE
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State | TN
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Zip | 37040-5248
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Country | US
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Telephone | 803-290-6529
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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 | CSW009829
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License Number State | GA
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