Provider Demographics
NPI:1982805016
Name:GRAY, CATHLEEN (PHD,LICSW)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:PHD,LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 502
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4629
Mailing Address - Country:US
Mailing Address - Phone:202-537-5922
Mailing Address - Fax:
Practice Address - Street 1:4801 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 502
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4629
Practice Address - Country:US
Practice Address - Phone:202-537-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3009571041C0700X
MD003611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical