MEDICARE: LESLIE MARIE GRAY LPC

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
1	101YM0800X	Mental Health Counselor	2100	KS
2	101YM0800X	Mental Health Counselor	2011021465	MO
3	101YM0800X	Mental Health Counselor	MH17037	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1487900619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE MARIE GRAY LPC

Provider Business Mailing Address
First Line	:	4140 NW 27TH LN STE F
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6600
Country	:	US
Telephone Number	:	386-717-6134
Fax Number	:

Provider Business Practice Location Address
First Line	:	4140 NW 27TH LN STE F
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6600
Country	:	US
Telephone Number	:	386-717-6134
Fax Number	:

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

Provider Enumeration Date	:	07/25/2012
Last Update Date	:	04/06/2026

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Directions to “ LESLIE MARIE GRAY LPC” Practice Location

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