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SHANDERICO GRAY
NPI 1689240707
Counselor - Mental Health in Crestview, FL

Active since May 29, 2021
2802 TITLEIST LN, CRESTVIEW, FL 32539(256) 365-6073 Get Directions Write a Review

NPPES record last updated: May 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shanderico Gray NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANDERICO GRAY (NPI 1689240707) is an individual mental health provider in Crestview, Florida, licensed in Florida (PMH1761) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1689240707
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHANDERICO GRAY
Location Address2802 TITLEIST LNCrestview, FL 32539-8335
Mailing Address2802 Titleist LnCrestview, FL 32539-8335 · (256) 365-6073
Phone(256) 365-6073
Sole ProprietorYes
Enumeration DateMay 29, 2021
NPPES CertifiedMay 29, 2021
✔ NPI 1689240707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · PMH1761
2802 TITLEIST LN, Crestview, FL 32539
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shanderico Gray's NPI number?

The NPI number for Shanderico Gray is 1689240707. It was assigned to this individual provider in the NPPES registry on May 29, 2021.

Where is Shanderico Gray located?

Shanderico Gray practices at 2802 Titleist Ln, Crestview, FL 32539. The listed phone number is (256) 365-6073.

What is Shanderico Gray's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Shanderico Gray was last updated on May 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.