Provider Demographics
NPI:1790367415
Name:AMANDA PASLEY GRAY, LPC, PLLC
Entity Type:Organization
Organization Name:AMANDA PASLEY GRAY, LPC, PLLC
Other - Org Name:AMANDA GRAY COUNSELING & SUPERVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPCS
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:512-650-9252
Mailing Address - Street 1:1401 SANDIA PLZ
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-4356
Mailing Address - Country:US
Mailing Address - Phone:512-650-9252
Mailing Address - Fax:
Practice Address - Street 1:1401 SANDIA PLZ
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-4356
Practice Address - Country:US
Practice Address - Phone:512-650-9252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty