Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Latoya Gray

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1104625508

Latoya Gray is a Nurse Practitioner in Fayetteville, Georgia. Qualified in 2024, 2 years ago. Practices with Avant Behavioral Consultants Inc, a 16-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2025
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

805 Lanier Ave E
Fayetteville, GA 30214-2204
Phone: (770) 694-6349
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence RN282463 (GA)

Record details

NPI number1104625508
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 10, 2025
Last updated in NPPESMarch 10, 2025
Certification dateMarch 10, 2025
Mailing address805 Lanier Ave E, Fayetteville, GA 30214-2204

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Avant Behavioral Consultants Inc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fayetteville