Organization
DAVID GRAY P.C.
Active
Other names
Gray Matter Therapy, Gray Therapeutics
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID S GRAY LCPC (PRESIDENT)
(440) 714-8822
Entity
Organization
Contact information
Practice address
1580 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3764
(440) 714-8822
Mailing address
22072 W ENGLE DR, LAKE VILLA, IL 60046-5411
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649636077
NPI
IL
Enumeration date
03/25/2019
Last updated
06/10/2019
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