Gray, Gary Russel
Gray, Gary Russel is an sole proprietor health care provider with primary practice located at 1101 Belcher Rd S Suite E, Largo FL 33771-3356. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Gray, Gary Russel can be contacted via phone (727) 421-3014.Contact Information
Primary practice address
1101 Belcher Rd S Suite E
Largo FL 33771-3356
Phone: (727) 421-3014
Fax: (727) 524-1332
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH 2804 FL | Florida |
Profile Details
| NPI number | 1629028675 |
|---|---|
| LBN Legal business name | Gray, Gary Russel |
| Credentials | MA, LMHC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2006 |
| Last updated | Jun 26th, 2012 - about 12 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 | 1629028675 | NPPES |
| Florida | Other | 593631612 | EMPLOYER TAX ID |
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