Individual
LISA L. GREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAC
Contact information
Practice address
2611 FAUNA RD, LEBO, KS 66856
(620) 757-1059
(620) 256-9000
Mailing address
PO BOX 106, LEBO, KS 66856-0106
(620) 757-1059
(620) 256-9000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
605
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12691970
CAQH
KS
Enumeration date
10/22/2014
Last updated
11/07/2019
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