Kimberly Jean Gray, MS, LPC, CM

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C6574 Issued in OR

Practice address

2650 Suzanne Way Ste 120
Eugene, OR 97408-7619

Phone

(541) 345-2800

Fax

(541) 345-4419

NPI assigned

Feb 13, 2007

Last updated

Jun 30, 2026By the provider in NPPES

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bandon Community Health CenterGroup PAC ID 1557416757, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bandon Community Health Center

  • Primary Care Clinic/Center
  • Bandon, OR
  • NPI 1033348289
  Medicare reassignment Care Compare group NPD
• Adapt

  • Addiction (Substance Use Disorder) Counselor
  • Roseburg, OR
  • NPI 1720010549

  Mental Health

  Medicare reassignment NPD
• Amber Benson Pmhnp PC

  dba Benson Health Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
  • NPI 1912042862
  Medicare reassignment NPD
• Lane County Oregon

  dba Community health Centers of Lane County

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314
  Medicare reassignment
• Adapt

  dba Adapt Integrated Health Care

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1184350811
  NPD
• Adapt

  dba Adapt Integrated Health Care

  • Federally Qualified Health Center (FQHC)
  • Bandon, OR
  • NPI 1194529289
  NPD
• Bandon Community Health Ctr

  dba Coast Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Port Orford, OR
  • NPI 1013587484
  NPD
• Willamette Community Health Solutions

  dba Cascade Health Solutions

  • Social Worker
  • Eugene, OR
  • NPI 1982855219

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1629110853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 KINSROW AVE APT 319",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 SUZANNE WAY STE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087619",
            "telephone_number": "541-345-2800",
            "fax_number": "541-345-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "credential": "MS, LPC, CM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C6574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500796814",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "12140003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3893",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Tyler Graves, THW
• Christine Noel Gray, PSS
• Freddie Gray
• Jeanene Gray
• Jennifer Rebecca Gray, RPH
• Kurt Matthew Gray
• Laurie P Gray, MD
• Steven Hugh Gray, LMT
• Richard Graymer
• Emmy Kate Greatwood

• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.