| Cara Jean Gray, L.c.s.w., Llc | |
|
1606 Gloucester St Brunswick GA 31520-7145 | |
| (912) 506-1163 | |
| Not Available |
| Full Name | Cara Jean Gray, L.c.s.w., Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1606 Gloucester St, Brunswick, Georgia |
| Authorized Official Name and Position | Carajean Gray (OWNER) |
| Authorized Official Contact | 9125061163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cara Jean Gray, L.c.s.w., Llc 141 Walden Shores Ln Brunswick GA 31525-4673 Ph: (912) 506-1163 | Cara Jean Gray, L.c.s.w., Llc 1606 Gloucester St Brunswick GA 31520-7145 Ph: (912) 506-1163 |
| NPI Number | 1699201756 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 05/11/2017 |
| Medicare PECOS PAC ID | 5991079790 |
|---|---|
| Medicare Enrollment ID | O20170918001592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699201756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CSW006049 (Georgia) | Primary |
| Provider Name | Carajean Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205216405 PECOS PAC ID: 6305158346 Enrollment ID: I20170918001508 |
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