Provider Demographics
NPI:1346365475
Name:GREY, PATRICIA FRANCES (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:FRANCES
Last Name:GREY
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IN
Mailing Address - Zip Code:47033-0042
Mailing Address - Country:US
Mailing Address - Phone:812-934-5266
Mailing Address - Fax:317-841-1157
Practice Address - Street 1:6470 N SHADELAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4390
Practice Address - Country:US
Practice Address - Phone:317-849-9509
Practice Address - Fax:317-841-1157
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH82801101YA0400X
IN39000684A101YM0800X
OHS 00163841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical