Individual provider Active NPI

Martha A Gray, LPC-S, RPT-S

  • School Counselor
  • Saint Louis, MO
National Provider Identifier
1710524145
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
2012037403 Issued in MO
Practice address
5279 Fyler Ave
Saint Louis, MO 63139-1300
Phone
(314) 881-2553
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 2012037403 MO Primary

Addresses

Primary practice location

5279 Fyler Ave
Saint Louis, MO 63139-1300

Mailing address

5279 Fyler Ave
Saint Louis, MO 63139-1300
Phone (314) 881-2553

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL www.premiercharterschool.org
CONNECT URL www.premiercharterschool.org
CONNECT URL www.premiercharterschool.org

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
2012037403MOMDSchool Counselor

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1710524145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5279 FYLER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391300",
            "telephone_number": "314-881-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5279 FYLER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391300",
            "telephone_number": "314-881-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MARTHA",
        "middle_name": "A",
        "credential": "LPC-S, RPT-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MO",
            "license": "2012037403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.premiercharterschool.org",
            "affiliation": "N",
            "address_1": "5279 Fyler Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631391300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.premiercharterschool.org",
            "affiliation": "N",
            "address_1": "5279 Fyler Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631391300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.premiercharterschool.org",
            "affiliation": "N",
            "address_1": "5279 Fyler Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631391300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.