Katlyn Cheree Gray, LMSW

Individual provider Active NPI Clinical Social Worker · Scurry, TX

NPI 1043889447 · NPPES record last updated Jun 21, 2021

Key facts

NPI
1043889447
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
105009 (TX)
Practice address
6950 Shady LN
Scurry, TX 75158-2831
Phone
(469) 721-6621
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
105009TXMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 105009 TX Yes

Addresses

Primary practice location

6950 Shady LN
Scurry, TX 75158-2831

Mailing address

4812 Union Park Blvd E
Aubrey, TX 76227-1528
Phone (469) 540-8200

Other names

  • Katlyn Cheree Fisher Former name

Electronic endpoints

TypeEndpointUseAffiliation
Other URL www.vertavahealth.com Health Information Exchange (HIE)

Other providers in Scurry, TX

All providers in Scurry, TX · Clinical Social Worker in Texas

Sources for this page

Verify at the official NPI Registry.