MEDICARE: DESTINI GRAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1013888429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINI GRAY

Provider Business Mailing Address
First Line	:	131 TOWN CENTER PKWY APT 2404
Second Line	:
City	:	MADISON HEIGHTS
State	:	VA
Zip	:	24572-5469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1075 LIGHT BLVD
Second Line	:
City	:	FOREST
State	:	VA
Zip	:	24551-5094
Country	:	US
Telephone Number	:	434-384-1594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	09/17/2025

Similar Medicare Providers

1184588972 — EVAN TYLER
Practice Location Address:

1075 LIGHT BLVD
FOREST, VA
24551-5094

Practice Phone: 434-384-1594
Practice Fax:

1154422764 — LIGHT COUNSELING, INC.
Practice Location Address:

1075 LIGHT BLVD
FOREST, VA
24551-5094

Practice Phone: 434-384-1594
Practice Fax: 434-384-3228

1285960773 — AMY S FEIGEL M.A., LPC
Practice Location Address:

1075 LIGHT BLVD STE B
FOREST, VA
24551-5094

Practice Phone: 434-384-1594
Practice Fax:

1457235525 — ALYSSA JOY PENROD LMFT
Practice Location Address:

1075 LIGHT BLVD
FOREST, VA
24551-5094

Practice Phone: 888-808-6050
Practice Fax:

1154291680 — ARPENIK STEPANYAN
Practice Location Address:

1075 LIGHT BLVD
FOREST, VA
24551-5094

Practice Phone: 832-794-0515
Practice Fax:

1285656082 — BILLY D HALEY OD
Practice Location Address:

1825 GRAVES MILL RD
FOREST, VA
24551-3967

Practice Phone: 434-385-5600
Practice Fax: 434-455-7172

Directions to “ DESTINI GRAY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.