ANGUS MATTHEW GRAY (NPI# 1760020432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760020432 |
| Entity Type | Individual |
| Full Name | ANGUS MATTHEW GRAY |
| Credential | QMHA |
| Practice Address |
1911 Hazel Ave Medford OR 97501-1630 |
| Mailing Address |
1215 Sw G St Grants Pass OR 97526-2544 |
| Practice Telephone | 5414729939 |
| Mailing Telephone | 5414762373 |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2019-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1911 HAZEL AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-1630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306912324 | Benjamin Matthew Bryan | Social Worker | 1911 Hazel Ave, Medford, OR 97501-1630 | 2006-11-28 |
| 1245842277 | John Trent Stoy | Counselor | 1911 Hazel Ave, Medford, OR 97501-1630 | 2020-08-20 |
| 1093365413 | Giovanna Peitz | Counselor | 1911 Hazel Ave, Medford, OR 97501-1630 | 2019-09-17 |
| 1417507427 | Tanya Lore Weeks | Counselor | 1911 Hazel Ave, Medford, OR 97501-1630 | 2019-09-12 |
| 1710530472 | Norman Treminio Castillo Iv | Counselor | 1911 Hazel Ave, Medford, OR 97501-1630 | 2019-07-22 |
| 1972085959 | Lauren Tuosto | Counselor | 1911 Hazel Ave, Medford, OR 97501-1630 | 2018-09-05 |
| 1508313503 | Kathleen Borden | Counselor | 1911 Hazel Ave, Medford, OR 97501 | 2016-09-07 |
| 1548511694 | Options for Southern Oregon | Community Based Residential Treatment Facility, Mental Illness | 1911 Hazel Ave, Medford, OR 97501-1630 | 2012-09-28 |
| 1144596115 | Jcmh - Hazel Center | Case Management | 1911 Hazel Ave, Medford, OR 97501-1630 | 2012-03-23 |
| 1861762809 | Ian Joseph Moore | Specialist | 1911 Hazel Ave, Medford, OR 97501 | 2012-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1689223901 | Holly Hermes | Counselor | 48 Hawthorne St, Medford, OR 97504-7114 | 2019-09-09 |
| 1417473554 | Elysee H. Castor | Counselor | 5 High St., Suite 101, Medford, MA 02155 | 2017-08-21 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1336597541 | Joanna Lea Ballard | Counselor | 1175 E Main St Ste C1, Medford, OR 97504-7457 | 2016-05-27 |
| 1386018240 | Sarie R Scully | Counselor | 26 Horseshoe Curv, Medford, NJ 08055-9751 | 2015-11-16 |
| 1992103451 | Sean Alexander Mickelson | Counselor | 358 S Oakdale Ave, Medford, OR 97501-3131 | 2014-12-16 |
| 1134472863 | Lynette J Milligan | Counselor | 142 N Ivy St Ste 2, Medford, OR 97501-2758 | 2012-10-18 |
| 1154687689 | Phylicia Mcdonald | Counselor | 176 Jerome St, Medford, MA 02155-3535 | 2012-04-10 |
| 1215205901 | Shelly Hohl | Counselor | 1000 E Main St Bldg B, Medford, OR 97504-7449 | 2011-12-08 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.