Tait Enis Gray, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

604327376 Issued in WA

Practice address

118 E 8TH St
Port Angeles, WA 98362-6129

Phone

(360) 457-0431

Fax

(360) 457-0493

NPI assigned

Oct 9, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/peninsulabehavioral/r4/

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.

• Core Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, WA
  • NPI 1639693781
  NPD (past)
• Peninsula Behavioral Health

  • Community/Behavioral Health Agency
  • Port Angeles, WA
  • NPI 1760519060
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1235604943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626129",
            "telephone_number": "360-457-0431",
            "fax_number": "360-457-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626129",
            "telephone_number": "360-457-0431",
            "fax_number": "360-457-0493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 S Still Rd",
            "address_purpose": "LOCATION",
            "city": "Sequim",
            "state": "WA",
            "postal_code": "983823577",
            "country_code": "US",
            "telephone_number": "360-775-5358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "TAIT",
        "middle_name": "ENIS",
        "name_prefix": "Mr.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "604327376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "604327376",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dirk Antony Gouge, DO
• Wendy Gourley
• Patrick Graham
• Heather D Gray, RN
• Mark Robert Gray, MA
• Lorin Green, LMP
• Karsi J Grego, ARNP, RN
• Derek Lee Greul, CO60912368
• Kelly Griffith
• Charles Gross

• Mental Health Counselor in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.