Provider Demographics
NPI:1235506650
Name:GRAY, L LAYLA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:L
Middle Name:LAYLA
Last Name:GRAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 W 21ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1559
Mailing Address - Country:US
Mailing Address - Phone:757-622-6794
Mailing Address - Fax:
Practice Address - Street 1:919 W 21ST ST STE B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1559
Practice Address - Country:US
Practice Address - Phone:757-622-6794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006064101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional