Provider Demographics
NPI:1194071837
Name:HAMMOND-CRAY, JEANETTE ELAINE (MA, LPC, CACIII)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:ELAINE
Last Name:HAMMOND-CRAY
Suffix:
Gender:F
Credentials:MA, LPC, CACIII
Other - Prefix:MS
Other - First Name:JEANETTE
Other - Middle Name:ELAINE
Other - Last Name:HAMMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:715 HORIZON DR STE 225
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2808 NORTH AVE FL 3
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-5155
Practice Address - Country:US
Practice Address - Phone:970-241-6023
Practice Address - Fax:970-683-7277
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0004398101YA0400X
COLPC.0001996101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)