Marlise V. Gray, M.ED., LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC003796 Issued in GA

Practice address

2013 Devonshire Dr. Suite 115
Columbus, GA 31904

Phone

(706) 576-6575

Fax

(706) 507-0590

NPI assigned

Jul 19, 2018

Last updated

Jul 19, 2018By the provider in NPPES

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

Master of Education

State licenses

Practice roles

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

• Landmark Counseling Services, LLC

  • Point of Service
  • Columbus, GA
  • NPI 1457541823
  NPD (past)

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1033696372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 DEVONSHIRE DR. SUITE 115",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-576-6575",
            "fax_number": "706-507-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 DEVONSHIRE DR. SUITE 115",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-576-6575",
            "fax_number": "706-507-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MARLISE",
        "middle_name": "V.",
        "name_prefix": "Ms.",
        "credential": "M.ED., LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC003796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON-MEDICARE",
            "identifier": "208008890",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimby Graves, LPC
• Andrew Jack Gray, MCD
• Gretchen Steffey Gray, PHARMD
• Kaitlin Elizabeth Gray
• Le'Annisha Gray
• Marquetta Gray
• Megan Claire Gray, M.S., CCC-SLP
• Andre Grays
• Greater Columbus PCH (Bevevolent PCH Inc.)
• Greater Image Healthcare, Corp.

• Mental Health Counselor in Columbus, GA
• Providers in Columbus, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.