Individual provider Active NPI

Jason Gray, LPC, LADC

  • Professional Counselor
  • Southbury, CT
National Provider Identifier
1164874475
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7232 Issued in CT
Practice address
33 Bullet Hill Rd Ste 301
Southbury, CT 06488-4697
Phone
(203) 673-1099
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7232 CT Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 001368 CT

Addresses

Primary practice location

33 Bullet Hill Rd Ste 301
Southbury, CT 06488-4697

Mailing address

33 Bullet Hill Rd Ste 216
Southbury, CT 06488-4699
Phone (203) 673-1099

Other practice location 1

2 Corporate Dr Ste 146
Shelton, CT 06484-6238
Phone (203) 673-1099

Other identifiers 1

IdentifierTypeStateIssuer
1164874475MedicaidCT

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

State licenses

LicenseStateTypeSpecialty
001368CTMDAddiction (Substance Use Disorder) Counselor
7232CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Litchfield Counseling LLC Professional Current Accepting new patients
Newtown Counseling Center LLC Addiction (Substance Use Disorder) CurrentSince Oct 21, 2025 Accepting new patients
Arms Acres Inc Past Accepting new patients
Arms Acres Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1164874475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BULLET HILL RD STE 216",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884699",
            "telephone_number": "203-673-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 BULLET HILL RD STE 301",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884697",
            "telephone_number": "203-673-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Corporate Dr Ste 146",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064846238",
            "country_code": "US",
            "telephone_number": "203-673-1099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JASON",
        "credential": "LPC, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "7232",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "001368",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164874475",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.