Gray, Bernard George
Gray, Bernard George is an sole proprietor health care provider with primary practice located at 14 Park Ln , Jamaica Plain MA 02130-2906. He recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Gray, Bernard George can be contacted via phone (800) 923-0460.Contact Information
Primary practice address
14 Park Ln
Jamaica Plain MA 02130-2906
Phone: (800) 923-0460
Fax: (617) 524-1045
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 1315 | Massachusetts |
Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X | 1315 | Massachusetts |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1315 | Massachusetts |
Behavioral Health & Social Service Providers / Family | 103TF0000X | 1315 | Massachusetts |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1315 | Massachusetts |
Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 1315 | Massachusetts |
Profile Details
NPI number | 1912033648 |
---|---|
LBN Legal business name | Gray, Bernard George |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 26th, 2007 |
Last updated | Feb 5th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1912033648 | NPPES |
Massachusetts | Other | WO1138 | BLUE CROSS BLUE SHIELD |
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