Active NPI
Marjory Roberts Gray, PH.D.
- Clinical Psychologist
- South Hadley, MA
National Provider Identifier
1093725210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS01590
- Practice address
- 27 College St
South Hadley, MA 01075-6461 - Phone
- (413) 536-2662
- Fax
- (413) 536-2662
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS01590 | RI | Primary |
Addresses
Primary practice location
27 College St
South Hadley, MA 01075-6461
Mailing address
16 Stanton Rd
Portsmouth, RI 02871-3519
Phone (413) 626-4966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 31, 2024 through May 31, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS01590 | RI | MD | Clinical Psychologist |
| 8238 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486598400000",
"number": "1093725210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 STANTON RD",
"city": "PORTSMOUTH",
"state": "RI",
"postal_code": "028713519",
"telephone_number": "413-626-4966",
"fax_number": "413-293-0693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 COLLEGE ST",
"city": "SOUTH HADLEY",
"state": "MA",
"postal_code": "010756461",
"telephone_number": "413-536-2662",
"fax_number": "413-536-2662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "MARJORY",
"middle_name": "ROBERTS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2017-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS01590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Hadley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.