Marlene A Gray
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Selawik, AK
NPI 1477079416 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1477079416
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 180 Tundra Road
Selawik, AK 99770-0180 - Phone
- (907) 484-2199
- Fax
- (907) 484-2119
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniilaq Association | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | Yes |
Addresses
Primary practice location
180 Tundra Road
Selawik, AK 99770-0180
Mailing address
PO Box 180
Selawik, AK 99770-0180
Phone (907) 484-2199
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0600402000 | Medicaid | AK |
Other providers in Selawik, AK
- Krystal Suzanne Ballot
- Jenny C Cleveland
- Warren Compton
- Esther Dexter
- Bertha Greist
- Mildred Sarah Greist
- Mary Lorraine Hingsbergen
- Maniilaq Association
- Maniilaq Association
All providers in Selawik, AK · Addiction (Substance Use Disorder) Counselor in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.