Mitchell G Grayson, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11574 Issued in TX

Practice address

950 N 4TH St
Longview, TX 75601-5436

Phone

(903) 758-0596

Fax

(903) 234-1639

NPI assigned

Jul 11, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1194080515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6800",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756086800",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015436",
            "telephone_number": "903-758-0596",
            "fax_number": "903-234-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "MITCHELL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Nichole Gramse, RN
• Julie Dianne Grant, M.S., CCC-SLP
• Jamie Dawn Graves, FNP-C
• Bailey Deann Gray
• Miranda Lynn Gray, MSN, APRN, FNP-C
• Monica J Grayson, LCDC
• Greater Hospice of Texas, Inc.
• Evelyn L Green, FNP
• Haley Green, M.A. CCC-SLP
• Juanita Bell Green

• Addiction (Substance Use Disorder) Counselor in Longview, TX
• Providers in Longview, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.