Provider Demographics
NPI:1346275765
Name:CRAY, KATHRYN F (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:F
Last Name:CRAY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 AUGUSTINE AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4606
Mailing Address - Country:US
Mailing Address - Phone:540-310-4070
Mailing Address - Fax:540-310-4072
Practice Address - Street 1:1802 AUGUSTINE AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4606
Practice Address - Country:US
Practice Address - Phone:540-310-4070
Practice Address - Fax:540-310-4072
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040016771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA031865OtherVALUE OPTIONS
VA461565OtherANTHEM BC/BS
VA8018OtherUBH
VA8915474Medicaid
VA40109680001OtherCIGNA
DC5329OtherCARE FIRST
VA7605145OtherAETNA
VA17873OtherNCPPO