Thomas D Gray, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-21655 Issued in AZ

Practice address

5100 E Highway 90 Ste B
Sierra Vista, AZ 85635-2444

Phone

(520) 732-3621

NPI assigned

Apr 25, 2023

Last updated

Apr 25, 2023By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 14, 2025 through Apr 14, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1639867989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 E HIGHWAY 90 STE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352444",
            "telephone_number": "520-732-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 E HIGHWAY 90 STE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352444",
            "telephone_number": "520-732-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "THOMAS",
        "middle_name": "D",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-21655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Goulding, PT, OCS
• GP Medicine, PLLC (Family Health Center of Sierra Vista)
• Christopher Hugh Grant Jr., DPT
• Christine Grassman, NP
• Emily Serena Graves, D.O.
• Danielle Ernestine Green, DMD
• Grieving the Child (Cornerstone Counseling)
• Justin Griffin
• Anyssa M Guajardo, PT, LAT, ATC
• Vincent Guarino, MD

• Mental Health Counselor in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.