MEDICARE: STACEY GRAY CPC

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	101YP2500X	Professional Counselor	CP1185	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CI0118	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1891194585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY GRAY CPC

Provider Business Mailing Address
First Line	:	2542 SUNGOLD DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-8890
Country	:	US
Telephone Number	:	702-569-1917
Fax Number	:

Provider Business Practice Location Address
First Line	:	6628 SKY POINTE DR STE 115
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4071
Country	:	US
Telephone Number	:	702-620-9354
Fax Number	:	702-935-8945

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

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	05/21/2021

Similar Medicare Providers

1205109683 — MS. CHRISTINE ZAZZERI MSC, MFCT
Practice Location Address:

6628 SKY POINTE DR STE 106
LAS VEGAS, NV
89131-4071

Practice Phone: 702-244-0067
Practice Fax:

1043564958 — HOLLY CARABAJAL
Practice Location Address:

6628 SKY POINTE DR STE 114
LAS VEGAS, NV
89131-4071

Practice Phone: 702-704-5112
Practice Fax:

1427407014 — MRS. JANELLE CAROLYN WELCH-OLIVER FNP-BC, NP-C, PMHNP
Practice Location Address:

6628 SKY POINTE DR STE 103
LAS VEGAS, NV
89131-4071

Practice Phone: 702-550-9199
Practice Fax: 702-935-8946

1922558832 — HANNAH NICOLE MCCALLSON
Practice Location Address:

6628 SKY POINTE DR STE 114
LAS VEGAS, NV
89131-4071

Practice Phone: 702-704-5112
Practice Fax: 186-663-3925

1215457528 — CHELSEA OVIATT
Practice Location Address:

6628 SKY POINTE DR STE 114
LAS VEGAS, NV
89131-4071

Practice Phone: 702-449-0004
Practice Fax:

1528575271 — KASIA MARIE CALDWELL MSW, LCSW
Practice Location Address:

6628 SKY POINTE DR STE 115
LAS VEGAS, NV
89131-4071

Practice Phone: 702-751-4378
Practice Fax: 702-924-5865

Directions to “ STACEY GRAY CPC” 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.