Mr Jordan Robert Gray, PRO COUNSELOR in Provo, UT

Mr Jordan Robert Gray, PRO COUNSELOR is a medicare enrolled "Counselor - Mental Health" provider in Provo, Utah. His current practice location is 151 S University Ave Ste 1500, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 851-7112.

Mr Jordan Robert Gray is licensed to practice in Utah (license number 7903342-6004) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1235414350.

Contact Information

	Mr Jordan Robert Gray, PRO COUNSELOR
	151 S University Ave Ste 1500, Provo, UT 84601-4427
	(801) 851-7112
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Jordan Robert Gray
Gender	Male
Speciality	Counselor - Mental Health
Location	151 S University Ave Ste 1500, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235414350
Provider Enumeration Date: 10/20/2011
Last Update Date: 06/10/2020

Medicare PECOS Information:

PECOS PAC ID: 9133563018
Enrollment ID: I20240219003423

Medical Identifiers

Medical identifiers for Mr Jordan Robert Gray such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235414350	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	7903342-6009 (Utah)	Secondary
101YM0800X	Counselor - Mental Health	7903342-6004 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jordan Robert Gray allows following entities to bill medicare on his behalf.

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

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jordan Robert Gray is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

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

Reviews and Comments

Counselor in Provo, UT

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: Medicare Enrolled 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

Mr Jordan Robert Gray, PRO COUNSELOR - Medicare Counselor in Provo, UT