Active NPI
Laurence Burton Gray Jr.
- Mental Health Counselor
- Moore, OK
National Provider Identifier
1093182339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 400 N Broadway St
Moore, OK 73160-4812 - Phone
- (405) 735-4650
- NPI assigned
- Aug 21, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
400 N Broadway St
Moore, OK 73160-4812
Mailing address
400 N Broadway St
Moore, OK 73160-4812
Phone (405) 735-4650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 83-0419474 | Other | OK | OKLAHOMA FAMILY COUNSELING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440115200000",
"number": "1093182339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N BROADWAY ST",
"city": "MOORE",
"state": "OK",
"postal_code": "731604812",
"telephone_number": "405-735-4650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N BROADWAY ST",
"city": "MOORE",
"state": "OK",
"postal_code": "731604812",
"telephone_number": "405-735-4650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "LAURENCE",
"middle_name": "BURTON",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-21",
"last_updated": "2015-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA FAMILY COUNSELING",
"identifier": "83-0419474",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.