Gray Therapy Group, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GRAY THERAPY GROUP, PLLC

Practice address

2501 Chatham Rd Ste N
Springfield, IL 62704-4188

Phone

(847) 834-9189

NPI assigned

Feb 1, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marissa Gray, LCSWNPI 1538722996

Title

Psychotherapist

Phone

(513) 407-2244

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marissa Gray, LCSW

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1538722996
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1003512112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE N",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "847-834-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE N",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "847-834-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY THERAPY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "513-407-2244",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "UNKNOWN",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "UNKNOWN",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Ann Graven, ACNP-BC
• Autumn Graves
• Christopher Mark Graves, MD
• Mark W Graves, MD
• Shannon Nicole Graves, APRN
• Blake Ashley Gray, MD
• Marissa Gray, LCSW
• Michael R Gray
• Great Health Medical Afil, P.C.
• Great Lakes Caring Hospice C Il, LLC

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.