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General NPI Number Information
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NPI Number | 1821711573
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Entity Type | Individual
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Provider Name | PETER WILLIAM GRAY LICSW
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Gender | Male
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 664 STEVENS RD
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City | SWANSEA
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State | MA
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Zip | 02777-4701
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Country | US
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Telephone | 508-397-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 2 COVESIDE CT
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City | EAST GREENWICH
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State | RI
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Zip | 02818-4601
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Country | US
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Telephone | 401-714-2280
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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 | ISW03728
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 125911
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License Number State | MA
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