| Mr Jordan Robert Gray, PRO COUNSELOR | |
|
151 S University Ave Ste 1500, Provo, UT 84601-4427 | |
| (801) 851-7112 | |
| Not Available |
| Full Name | Mr Jordan Robert Gray |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 15 Years |
| Location | 151 S University Ave Ste 1500, Provo, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235414350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 7903342-6009 (Utah) | Secondary |
| 101YM0800X | Counselor - Mental Health | 7903342-6004 (Utah) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wasatch Behavioral Health Special Service District | 2567367915 | 78 |
| Entity Name | Wasatch Behavioral Health Special Service District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356357115 PECOS PAC ID: 2567367915 Enrollment ID: O20031129000014 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jordan Robert Gray, PRO COUNSELOR 750 N Freedom Blvd, Provo, UT 84601-1677 Ph: (801) 373-4760 | Mr Jordan Robert Gray, PRO COUNSELOR 151 S University Ave Ste 1500, Provo, UT 84601-4427 Ph: (801) 851-7112 |
Susan Easton Black, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1190 N 900 E, Provo, UT 84604 Phone: 801-422-7620 Fax: 801-422-0165 | |
Daniel Howell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 619 N 500 W, Provo, UT 84601 Phone: 801-375-4240 Fax: 801-375-4241 | |
Vicki Goodman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 619 N 500 W, Provo, UT 84601 Phone: 801-420-0465 Fax: 801-375-4241 | |
Colbey Bentley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 717 N 1850 W, Provo, UT 84604 Phone: 801-375-4240 Fax: 801-375-4241 | |
Maurhy Alfredo Meneses, Counselor Medicare: Not Enrolled in Medicare Practice Location: 836 N 1375 W, Provo, UT 84604 Phone: 801-375-2523 Fax: 801-375-2523 | |
David Skiles, CMHC Counselor Medicare: Accepting Medicare Assignments Practice Location: 750 N Freedom Blvd, Provo, UT 84601 Phone: 801-373-4760 Fax: 801-373-0639 | |
Scott D Owen, PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3651 N 100 E Ste 100, Provo, UT 84604 Phone: 801-356-0014 Fax: 801-373-3655 |