Colleen J Gray, ED.D, LPC, CAADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009664 Issued in GA

Practice address

1147 Raleigh Way
Lawrenceville, GA 30043-5227

Phone

(215) 360-7322

NPI assigned

Feb 7, 2024

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Georgia Mountains Community Services

  • Mental Health Counselor
  • Cumming, GA
  • NPI 1063522035
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA, Professional

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  GA, Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1497519847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 RALEIGH WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 RALEIGH WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435227",
            "telephone_number": "215-360-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "COLLEEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "ED.D, LPC, CAADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nolan Gregory Graham, MD
• Grand Therapeutic Services LLC
• Krista Lee Granger, APRN
• Keionna Danay Grant, M.D.
• Sarah Elizabeth Grant, MPH, CHES, CDCES
• Elizabeth Nicole Gray, MSN, WHNP
• Erica Gray, PHARMD
• Gwendolyn Gray, CADC
• Jennifer Armacost Gray, AGACNP
• Robert Edward Gray Jr.

• Professional Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.