| Victoria Johnson Gray, LCSW | |
|
1350 Us Highway 62 W, Princeton, KY 42445-6106 | |
| (270) 365-2008 | |
| (270) 365-2009 |
| Full Name | Victoria Johnson Gray |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 1350 Us Highway 62 W, Princeton, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588122634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 256117 (Kentucky) | Primary |
| Entity Name | Kentucky Counseling Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932590338 PECOS PAC ID: 7618221300 Enrollment ID: O20181115002000 |
| Mailing Address | Practice Location Address |
|---|---|
| Victoria Johnson Gray, LCSW 1104 Holly Ln, Princeton, KY 42445-2327 Ph: (260) 963-1805 | Victoria Johnson Gray, LCSW 1350 Us Highway 62 W, Princeton, KY 42445-6106 Ph: (270) 365-2008 |
Sonja Lee Ramey, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1350 Us Highway 62 W, Princeton, KY 42445 Phone: 270-365-2008 | |
Breanne Nicolle Rogers, CSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1350 Us Highway 62 W, Princeton, KY 42445 Phone: 270-365-2008 | |
Shandi Lynne Damron, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1350 Us Highway 62 W, Princeton, KY 42445 Phone: 270-365-2008 Fax: 270-365-2009 |