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General NPI Number Information
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NPI Number | 1972970846
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Entity Type | Organization
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Legal Business Name | GRAY COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 180 MAIN ST
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City | CALHOUN
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State | KY
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Zip | 42327
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Country | US
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Telephone | 270-273-3050
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Fax | 270-273-3052
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Provider Business Mailing Address
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Address Line | PO BOX 654
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City | CALHOUN
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State | KY
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Zip | 42327-0654
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Country | US
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Telephone | 270-273-3050
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Fax | 270-273-3052
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ANNIE GRAY-DALTON
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Credential | LCSW
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Telephone | 270-273-3050
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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 | 3795
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License Number State | KY
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