| Edgar-gray Counseling, Pllc | |
|
2909 King St Ste A Jonesboro AR 72401-5322 | |
| (870) 351-5020 | |
| (870) 382-3025 |
| Full Name | Edgar-gray Counseling, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2909 King St Ste A, Jonesboro, Arkansas |
| Authorized Official Name and Position | Stanford James Gray (THERAPIST/OWNER) |
| Authorized Official Contact | 8703515020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgar-gray Counseling, Pllc 2802 Carriage Dr Jonesboro AR 72404-9057 Ph: (870) 351-5020 | Edgar-gray Counseling, Pllc 2909 King St Ste A Jonesboro AR 72401-5322 Ph: (870) 351-5020 |
| NPI Number | 1972010106 |
|---|---|
| Provider Enumeration Date | 01/09/2018 |
| Last Update Date | 03/10/2019 |
| Medicare PECOS PAC ID | 7810258589 |
|---|---|
| Medicare Enrollment ID | O20180221002328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972010106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Michelle L Hix |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922027655 PECOS PAC ID: 4284680513 Enrollment ID: I20050329001228 |
| Provider Name | Stanford J Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528002078 PECOS PAC ID: 7113948019 Enrollment ID: I20051207000527 |
| Provider Name | Erin E Snodgrass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669499240 PECOS PAC ID: 7214950690 Enrollment ID: I20070202000184 |
| Provider Name | Rebbecca A Wellborn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134328131 PECOS PAC ID: 5193908770 Enrollment ID: I20110318000499 |
| Provider Name | Carissa D Edgar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356618623 PECOS PAC ID: 3072874668 Enrollment ID: I20180427001213 |
| Provider Name | Angelica Reina Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629479605 PECOS PAC ID: 6709126329 Enrollment ID: I20190319000880 |
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