Provider Demographics
NPI:1710334057
Name:GRAY, LAKEITHA (LPC,NCC)
Entity Type:Individual
Prefix:MRS
First Name:LAKEITHA
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MANHATTAN BLVD BLDG D
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-3583
Mailing Address - Country:US
Mailing Address - Phone:504-905-3563
Mailing Address - Fax:504-353-9918
Practice Address - Street 1:1901 MANHATTAN BLVD BLDG D
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-3583
Practice Address - Country:US
Practice Address - Phone:504-905-3563
Practice Address - Fax:504-353-9918
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2690101YP2500X
LA5477101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional