Active NPI
Jason Gray, LPC, LADC
- Professional Counselor
- Southbury, CT
National Provider Identifier
1164874475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7232
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164874475 | Medicaid | CT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001368 | CT | MD | Addiction (Substance Use Disorder) Counselor |
| 7232 | CT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Litchfield Counseling LLC | Professional | Current | Accepting new patients |
| Newtown Counseling Center LLC | Addiction (Substance Use Disorder) | Current | 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.
-
- Professional Counselor
- Bethlehem, CT
- NPI 1730905118
-
- Professional Counselor
- Newtown, CT
- NPI 1396611968
Addiction (Substance Use Disorder)
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Carmel, NY
- NPI 1235184227
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Bronx, NY
- NPI 1649474552
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.