| Ms Marie Colette Gray, PHD; NCP; LPC;FAAGFS | |
|
1172 Twin Stacks Drive, Dallas, PA 18612-9178 | |
| (570) 674-1505 | |
| (570) 674-8679 |
| Full Name | Ms Marie Colette Gray |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1172 Twin Stacks Drive, Dallas, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265679997 | NPI | - | NPPES |
| 1023153600001 | Other | PA | DPW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PC003840 (Pennsylvania) | Primary |
| Entity Name | Safe Pathways Counseling Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548048903 PECOS PAC ID: 4981041134 Enrollment ID: O20240322002746 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Marie Colette Gray, PHD; NCP; LPC;FAAGFS 1172 Twin Stacks Dr, Dallas, PA 18612-8505 Ph: (570) 674-1505 | Ms Marie Colette Gray, PHD; NCP; LPC;FAAGFS 1172 Twin Stacks Drive, Dallas, PA 18612-9178 Ph: (570) 674-1505 |
Ms. Valerie Lee Noel, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1172 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1505 Fax: 570-674-8679 | |
Scott Joseph Preisel, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1172 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1505 Fax: 570-674-8679 | |
Ms. Jessica Alyssa Martin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1172 Twin Stacks Dr # 427, Dallas, PA 18612 Phone: 570-674-1505 Fax: 570-674-8679 | |
Matthew Debiase, M.S., N.C.C.,L.P.C. Counselor Medicare: Medicare Enrolled Practice Location: 1172 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1505 | |
Ms. Debra Passarella, M.A.,N.C.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1172 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1505 | |
Amy Lynn Roccograndi, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1172 Twin Stacks Dr, Dallas, PA 18612 Phone: 570-674-1505 Fax: 570-674-8679 |