Geneva Marie Gray, PHD, LPC, NCC, CPCS

Primary specialty

CounselorTaxonomy code 101Y00000X

License

0004236 Issued in GA

Practice address

2330 Scenic Hwy S
Suite 115
Snellville, GA 30078-3115

Phone

(770) 559-9919

Fax

(404) 891-5095

NPI assigned

Oct 15, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24100/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shades of Gray Wellness Center

  • Professional Counselor
  • Snellville, GA
  • NPI 1235487919
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1003068529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S",
            "address_2": "SUITE 115",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115",
            "telephone_number": "770-559-9919",
            "fax_number": "404-891-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S",
            "address_2": "SUITE 115",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115",
            "telephone_number": "770-559-9919",
            "fax_number": "404-891-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "GENEVA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, NCC, CPCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "0004236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922721756B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Prather Grant
• Whitney Grant, RBT
• Gravante Chiropractic & Nutrition Inc.
• Lorraine Scott Gravante, D.C.
• Patricia Theresa Gray-Smith, NURSE PRACTITIONER
• Karen Nguyen Gray, PA-C
• Mark A. Gray, D.M.D.
• Melissa Marie Gray, PMHNP
• Grayson Family Care
• Greater Gwinnett Internal Medicine Associates LLC

• Counselor in Snellville, GA
• Providers in Snellville, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.