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NPI Code Detail

MEDICARE: JEFFREY L GRAY LPCC

MEDICARE: JEFFREY L GRAY LPCC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor1196TN
2101YP2500XProfessional CounselorE.2404619OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477583094
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY L GRAY LPCC
Provider Business Mailing Address
First Line : 2680 W MARKET ST
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-4215
Country : US
Telephone Number : 234-867-5001
Fax Number :
Provider Business Practice Location Address
First Line : 2680 W MARKET ST
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-4215
Country : US
Telephone Number : 234-867-5001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 01/07/2026

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Directions to “ JEFFREY L GRAY LPCC” Practice Location

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