Brenda Joyce Gray, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2013037932 Issued in MO

Practice address

915 Highway 84 W
Caruthersville, MO 63830-8113

Phone

(573) 333-5875

Fax

(573) 359-5876

NPI assigned

Nov 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brenda Joyce Gray Professional name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Kennett, MO
  • NPI 1669477550
  Medicare reassignment

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1023521978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHWAY 84 W",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638308113",
            "telephone_number": "573-333-5875",
            "fax_number": "573-333-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 HIGHWAY 84 W",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638308113",
            "telephone_number": "573-333-5875",
            "fax_number": "573-359-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "BRENDA",
        "middle_name": "JOYCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013037932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "GRAY",
            "middle_name": "JOYCE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Xiomara Garcia
• John D Gardner, D.D.S.
• Heather German
• Glorious in Home and CDS LLC
• Grace Family Medical Clinic, LLC
• Guardian Angels CDS, LLC
• Guardian Angels in Home Services, LLC
• Guardian Angels in Home Services, LLC
• Latoya Shanta Guyton
• Jazmyne S Hall

• Clinical Social Worker in Caruthersville, MO
• Providers in Caruthersville, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.