LISA GRAY
NPI 1871105346
Counselor in Moraine, OH

Q: What is Lisa Gray's NPI number?

The NPI number for Lisa Gray is 1871105346. It was assigned to this individual provider in the NPPES registry on August 17, 2020.

Q: What is Lisa Gray's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: Is Lisa Gray enrolled in Medicare?

No. Lisa Gray has opted out of Medicare through October 17, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Lisa Gray was last updated on August 17, 2020. 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.

Active since August 17, 2020Opted out of Medicare · through Oct 17, 2026

3095 KETTERING BLVD, MORAINE, OH 45439(937) 293-8300 Get Directions Write a Review

NPPES record last updated: August 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Lisa Gray NPPES

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

LISA GRAY (NPI 1871105346) is an individual counselor in Moraine, Ohio and active in the NPI registry since August 2020. She has opted out of Medicare through October 17, 2026.

NPPES Registry Identity

NPI1871105346

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameLISA GRAY

Location Address3095 KETTERING BLVDMoraine, OH 45439-1983

Mailing Address3095 Kettering BlvdMoraine, OH 45439-1983 · (937) 293-8300

Phone(937) 293-8300

Sole ProprietorNo

Enumeration DateAugust 17, 2020

NPPES CertifiedAugust 17, 2020

✔ NPI 1871105346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

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.

3095 KETTERING BLVD, Moraine, OH 45439

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lisa Gray has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 17, 2024 through October 17, 2026.

Opt-Out Effective DateOctober 17, 2024

Opt-Out In Effect ThroughOctober 17, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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