Provider Demographics
NPI:1396250882
Name:GRAY, MEGAN MILLER (LCPC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MILLER
Last Name:GRAY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:B
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:10410 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-4042
Mailing Address - Country:US
Mailing Address - Phone:301-379-2086
Mailing Address - Fax:
Practice Address - Street 1:9520 BERGER RD STE 302
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1540
Practice Address - Country:US
Practice Address - Phone:301-310-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006972101YP2500X
MDLC8700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional