Provider Demographics
NPI:1295592897
Name:GRAY, NATALIE KATHLEAN (CADC-R)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:KATHLEAN
Last Name:GRAY
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5222 W MARKET STREET EXT
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-5608
Mailing Address - Country:US
Mailing Address - Phone:910-434-9446
Mailing Address - Fax:
Practice Address - Street 1:1504 JAKE ALEXANDER BLVD W
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1213
Practice Address - Country:US
Practice Address - Phone:704-645-8539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCADC-28539101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)