Katherine Gray
Individual provider Active NPI Mental Health Counselor · Cleveland, NM
NPI 1992416382 · NPPES record last updated Dec 7, 2022
Key facts
- NPI
- 1992416382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CTB-2022-0711 (NM)
- Practice address
- 153 County Road B019
Cleveland, NM 87715-8014 - Phone
- (505) 379-8188
- NPI assigned
- Dec 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CTB-2022-0711 | NM | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CTB-2022-0711 | NM | Yes |
Addresses
Primary practice location
153 County Road B019
Cleveland, NM 87715-8014
Mailing address
PO Box 395
Cleveland, NM 87715-0395
Other providers in Cleveland, NM
All providers in Cleveland, NM · Mental Health Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.