Individual
EMILY GRAY
Active
Individual
EMILY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCA, LCAS-A
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-22356
NC
101YP2500X
Professional Counselor
Primary
A11627
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154707115
—
NC
01
—
19FLF
BCBS
NC
Enumeration date
07/31/2015
Last updated
05/10/2017
Update your record
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