| Gray Therapy Group, Pllc | |
|
2501 Chatham Rd Ste N Springfield IL 62704-4188 | |
| (847) 834-9189 | |
| Not Available |
| Full Name | Gray Therapy Group, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2501 Chatham Rd Ste N, Springfield, Illinois |
| Authorized Official Name and Position | Marissa Gray (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5134072244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gray Therapy Group, Pllc 2501 Chatham Rd Ste N Springfield IL 62704-4188 Ph: (847) 834-9189 | Gray Therapy Group, Pllc 2501 Chatham Rd Ste N Springfield IL 62704-4188 Ph: (847) 834-9189 |
| NPI Number | 1003512112 |
|---|---|
| Provider Enumeration Date | 02/01/2023 |
| Last Update Date | 03/20/2023 |
| Certification Date | 03/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003512112 | NPI | - | NPPES |
| UNKNOWN | Other | IL | BLUE CROSS BLUE SHIELD |
| UNKNOWN | Other | IL | UNITED HEALTHCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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