Individual provider Active NPI

Randi Shuriee Gray, LPC, NCC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1639733520
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-16731 Issued in AZ
Practice address
3740 E Southern Ave Ste 209
Mesa, AZ 85206-2512
Phone
(480) 553-7743
NPI assigned
Apr 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-16731 AZ Primary

Addresses

Primary practice location

3740 E Southern Ave Ste 209
Mesa, AZ 85206-2512

Mailing address

3740 E Southern Ave Ste 209
Mesa, AZ 85206-2512
Phone (480) 553-7743

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 17, 2026 through Feb 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-16731AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Randi Gray Counseling Professional 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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1639733520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 E SOUTHERN AVE STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062512",
            "telephone_number": "480-553-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 E SOUTHERN AVE STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062512",
            "telephone_number": "480-553-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "RANDI",
        "middle_name": "SHURIEE",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-16731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.