Individual
JASON GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LADC
Contact information
Practice address
33 BULLET HILL RD STE 301, SOUTHBURY, CT 06488-4697
(203) 673-1099
Mailing address
33 BULLET HILL RD STE 216, SOUTHBURY, CT 06488-4699
(203) 673-1099
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
001368
CT
101YP2500X
Professional Counselor
Primary
7232
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164874475
—
CT
Enumeration date
07/11/2016
Last updated
10/30/2024
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