Provider Demographics
NPI:1477611614
Name:GRAY, ENOD L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ENOD
Middle Name:L
Last Name:GRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 MONTROSE BLVD
Mailing Address - Street 2:SUITE 540
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006
Mailing Address - Country:US
Mailing Address - Phone:713-522-7014
Mailing Address - Fax:713-522-1196
Practice Address - Street 1:4200 MONTROSE BLVD
Practice Address - Street 2:SUITE 540
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006
Practice Address - Country:US
Practice Address - Phone:713-777-7193
Practice Address - Fax:713-522-1196
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS251691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0005952OtherBCBS
0007976402OtherMAGELLAN
TX00058EMedicare ID - Type Unspecified