Roger C Gray, LAC, MAC, CCS, ADCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

96 Issued in SC

Practice address

21 Westminster PL
Beaufort, SC 29907-1967

Phone

(843) 252-2164

Fax

(843) 525-0082

NPI assigned

Jun 8, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1427284124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WESTMINISTER PL",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071967",
            "telephone_number": "843-252-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WESTMINSTER PL",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071967",
            "telephone_number": "843-252-2164",
            "fax_number": "843-525-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROGER",
        "middle_name": "C",
        "credential": "LAC, MAC, CCS, ADCII",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "1906264",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "96",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Celeste Graham
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• John William Gray III, MD
• Kevin O'Shea Green Sr., PTA, MLDT
• Jessica Greene, PTA
• Tristan Greenwalt, DMD
• Lora Grieco, LCSW
• Sally H. Griffith, CRNA

• Addiction (Substance Use Disorder) Counselor in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Addiction (Substance Use Disorder) Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.