Provider Demographics
NPI:1861684292
Name:SPRAY, CHARLES (LMHC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:SPRAY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 KEYSTONE WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3001
Mailing Address - Country:US
Mailing Address - Phone:317-914-5931
Mailing Address - Fax:775-288-3479
Practice Address - Street 1:969 KEYSTONE WAY STE 100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3001
Practice Address - Country:US
Practice Address - Phone:317-440-4176
Practice Address - Fax:775-288-3479
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001888A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor