Provider Demographics
NPI:1376425173
Name:CATHERINE GRAY, JOHN ERNEST (LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ERNEST
Last Name:CATHERINE GRAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:ERNEST
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1410 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-9615
Mailing Address - Country:US
Mailing Address - Phone:434-825-6814
Mailing Address - Fax:
Practice Address - Street 1:914 E JEFFERSON ST STE G4
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5376
Practice Address - Country:US
Practice Address - Phone:434-218-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040182001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical