Provider Demographics
NPI:1629838370
Name:GRAY, MARY-ELIZA JAYNE (LPC)
Entity type:Individual
Prefix:
First Name:MARY-ELIZA
Middle Name:JAYNE
Last Name:GRAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152 TRAVEE CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-4720
Mailing Address - Country:US
Mailing Address - Phone:303-994-9756
Mailing Address - Fax:
Practice Address - Street 1:210 W 3RD ST STE 1
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526-5004
Practice Address - Country:US
Practice Address - Phone:970-540-0219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0022570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health