Provider Demographics
NPI:1619315348
Name:GRAY, CURTIS EUGENE (MSW, LCSWA)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:EUGENE
Last Name:GRAY
Suffix:
Gender:M
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BARNES ST APT F17
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2241
Mailing Address - Country:US
Mailing Address - Phone:336-457-2078
Mailing Address - Fax:
Practice Address - Street 1:200 BARNES ST APT F17
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2241
Practice Address - Country:US
Practice Address - Phone:336-457-2078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0080751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical