Provider Demographics
NPI:1144232398
Name:GRAY, LOIS FREY (LCSW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:FREY
Last Name:GRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:
Other - Last Name:FREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1803 OREGON PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6401
Mailing Address - Country:US
Mailing Address - Phone:717-560-9969
Mailing Address - Fax:717-560-9553
Practice Address - Street 1:1803 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6401
Practice Address - Country:US
Practice Address - Phone:717-560-9969
Practice Address - Fax:717-560-9553
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW001385L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50056080OtherCAPITALBLUECROSS
PA810884OtherHIGHMARK
PA131478G09Medicare ID - Type UnspecifiedMEDICARE
PA810884OtherHIGHMARK