Provider Demographics
NPI:1134221435
Name:GRAY, REBECCA L (LMHC, MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:GRAY
Suffix:
Gender:F
Credentials:LMHC, MS, LPC
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:L
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REBECCA HORNER
Mailing Address - Street 1:238 N MASSACHUSETTS AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-4987
Mailing Address - Country:US
Mailing Address - Phone:863-223-3995
Mailing Address - Fax:
Practice Address - Street 1:238 N MASSACHUSETTS AVE FL 1
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-4987
Practice Address - Country:US
Practice Address - Phone:863-223-3995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SC6618101YP2500X
NC7508101YP2500X
FLMH22927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional