Active NPI
Bernard Paul Gray, LICDC, LSW
- Addiction (Substance Use Disorder) Counselor
- Cincinnati, OH
National Provider Identifier
1831553965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LICDC.872388
- Practice address
- 311 Martin Luther King Dr E
Cincinnati, OH 45219-2581 - Phone
- (513) 475-5331
- Fax
- (513) 332-0367
- NPI assigned
- Apr 5, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S-0018686 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LICDC.872388 | Primary |
Addresses
Primary practice location
311 Martin Luther King Dr E
Cincinnati, OH 45219-2581
Mailing address
311 Martin Luther King Dr E
Cincinnati, OH 45219-2581
Phone (513) 475-5331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S-0018686 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1831553965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 MARTIN LUTHER KING DR E",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452192581",
"telephone_number": "513-475-5331",
"fax_number": "513-332-0367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 MARTIN LUTHER KING DR E",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452192581",
"telephone_number": "513-475-5331",
"fax_number": "513-332-0367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "BERNARD",
"middle_name": "PAUL",
"credential": "LICDC, LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-05",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S-0018686",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": "LICDC.872388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.