Provider Demographics
NPI:1376702282
Name:GRAY, JAMIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1035 PLACER ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1125
Mailing Address - Country:US
Mailing Address - Phone:530-246-5710
Mailing Address - Fax:530-244-7846
Practice Address - Street 1:980 PLACER ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1126
Practice Address - Country:US
Practice Address - Phone:530-246-5710
Practice Address - Fax:530-244-7846
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23984101YM0800X
CA274631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health