Matthew T. Grey, MA, LCPC
Counselor, Professional in Pleasant Plains, IL. Individual provider (NPI-1).
NPI number1295060002
StatusActive
Last updated in NPPESApr 17, 2024
Details
- NPI
- 1295060002
- Entity type
- Individual (NPI-1)
- Name
- Mr. Matthew T. Grey
- Credential
- MA, LCPC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 12, 2009
- Certification date
- Apr 17, 2024
- Last updated
- Apr 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180.010767 | IL | Yes |
| 101YM0800X | Counselor, Mental Health | MH19280 | FL | |
| 101YM0800X | Counselor, Mental Health | 79502 | TX | |
| 101YM0800X | Counselor, Mental Health | 180.010767 | IL | |
| 101YP2500X | Counselor, Professional | MH19280 | FL | |
| 101YP2500X | Counselor, Professional | 79502 | TX |
Practice location
5400 Durango TrlPleasant Plains, IL 62677-4060
Phone 217-836-4642
Mailing address
5400 Durango TrlPleasant Plains, IL 62677-4060
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