Provider Demographics
NPI:1356231211
Name:DR. TARA GRAY COUNSELING & WELLNESS INC
Entity type:Organization
Organization Name:DR. TARA GRAY COUNSELING & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-769-9472
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:OPHIR
Mailing Address - State:CO
Mailing Address - Zip Code:81426-0810
Mailing Address - Country:US
Mailing Address - Phone:970-769-9472
Mailing Address - Fax:
Practice Address - Street 1:618 MOUNTAIN VILLAGE BLVD # 203C
Practice Address - Street 2:
Practice Address - City:TELLURIDE
Practice Address - State:CO
Practice Address - Zip Code:81435-9541
Practice Address - Country:US
Practice Address - Phone:970-769-9472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder