Provider Demographics
NPI:1851285613
Name:GRAY, ERICA (MA, LPC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 PINE BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-4947
Mailing Address - Country:US
Mailing Address - Phone:434-609-2089
Mailing Address - Fax:
Practice Address - Street 1:2203 GRAVES MILL RD STE C
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-4297
Practice Address - Country:US
Practice Address - Phone:434-602-8557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014667101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health