Provider Demographics
NPI:1689864670
Name:GRAY, HOLLY R (MS)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:R
Last Name:GRAY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:R
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:11417 CRANSTON DR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-6869
Mailing Address - Country:US
Mailing Address - Phone:719-886-4708
Mailing Address - Fax:719-886-4793
Practice Address - Street 1:7495 MCLAUGHLIN RD STE 200
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4714
Practice Address - Country:US
Practice Address - Phone:719-332-3394
Practice Address - Fax:719-886-4793
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist