Provider Demographics
NPI:1629846944
Name:GRAY, MALOREY (LPCA)
Entity Type:Individual
Prefix:
First Name:MALOREY
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:MORGANFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42437-1552
Mailing Address - Country:US
Mailing Address - Phone:270-952-3114
Mailing Address - Fax:
Practice Address - Street 1:111 S MORGAN ST
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-1552
Practice Address - Country:US
Practice Address - Phone:270-285-9023
Practice Address - Fax:270-285-9037
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY288431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health