Provider Demographics
NPI:1528328044
Name:GRAY, SARAH JAY (LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JAY
Last Name:GRAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5420
Mailing Address - Country:US
Mailing Address - Phone:601-421-5772
Mailing Address - Fax:
Practice Address - Street 1:2686 W OXFORD LOOP STE 125
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5427
Practice Address - Country:US
Practice Address - Phone:662-260-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2745101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health