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NPI Code Detail

MEDICARE: SARAH E GRAY

MEDICARE: SARAH E GRAY
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
1101YP2500XProfessional CounselorC.2002979OH
2101YA0400XAddiction (Substance Use Disorder) CounselorLICDC.162083OH
3101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.166457OH
4101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.162723OH
5101YA0400XAddiction (Substance Use Disorder) CounselorLCDCIII.161905OH

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 : 1720571573
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH E GRAY
Provider Business Mailing Address
First Line : 6460 HARRISON AVE STE 200
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7958
Country : US
Telephone Number : 513-941-4999
Fax Number : 513-694-0168
Provider Business Practice Location Address
First Line : 1718 CENTRAL PKWY
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-2355
Country : US
Telephone Number : 513-941-4999
Fax Number : 513-694-0168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2018
Last Update Date : 12/29/2023

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Directions to “ SARAH E GRAY ” Practice Location

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