Individual provider Active NPI

Cassandra Gray, LMFT

  • Addiction (Substance Use Disorder) Counselor
  • Louisville, KY
National Provider Identifier
1619303583
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ADLAD00223215 Issued in KY
Practice address
12730 Townepark Way
201
Louisville, KY 40243-2303
Phone
(502) 254-9555
Fax
(502) 254-9554
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 165751 KY
Mental Health Counselor 101YM0800X KY
Marriage & Family Therapist 106H00000X 273462 KY
Addiction (Substance Use Disorder) Counselor 101YA0400X ADLAD00223215 KY Primary

Addresses

Primary practice location

12730 Townepark Way
201
Louisville, KY 40243-2303

Mailing address

12730 Townepark Way
Louisville, KY 40243-2303
Phone (502) 254-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
165751KYMDAddiction (Substance Use Disorder) Counselor
ADLAD00223215KYMDAddiction (Substance Use Disorder) Counselor
273462KYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Spirits LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1619303583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12730 TOWNEPARK WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432303",
            "telephone_number": "502-254-9555",
            "fax_number": "502-254-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12730 TOWNEPARK WAY",
            "address_2": "201",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432303",
            "telephone_number": "502-254-9555",
            "fax_number": "502-254-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CASSANDRA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "165751",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "273462",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "ADLAD00223215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.