Gray, Stanford J

Gray, Stanford J is an individual health care provider with primary practice located at 2909 King St Ste A , Jonesboro AR 72401-5326. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Gray, Stanford J can be contacted via phone (870) 351-5020.

Contact Information

Primary practice address
2909 King St Ste A Jonesboro AR 72401-5326
Phone: (870) 351-5020
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1979-C Arkansas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1528002078
LBN Legal business name Gray, Stanford J
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Mar 10th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528002078 NPPES
Arkansas MEDICAID 171752795
Arkansas Other 5Y583
Arkansas Other 5Y583

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