Gray, James William

Gray, James William is an sole proprietor health care provider with primary practice located at 621 Main St Ste. G, Lewiston ID 83501-1871. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Gray, James William can be contacted via phone (208) 750-3000.

Contact Information

Primary practice address
621 Main St Ste. G Lewiston ID 83501-1871
Phone: (208) 750-3000
Fax: (208) 750-1244
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LMSW-31312 Idaho

Profile Details

NPI number 1649567959
LBN Legal business name Gray, James William
Credentials LMSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2011
Last updated Jul 7th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649567959 NPPES
Idaho MEDICAID 806162000

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