Individual provider Active NPI

Sharissa L Grey, LCSW

  • Clinical Social Worker
  • Visalia, CA
National Provider Identifier
1053891978
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121708 Issued in CA
Practice address
520 E Tulare Ave
Visalia, CA 93292-3629
Phone
(559) 623-0900
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 121708 CA Primary

Addresses

Primary practice location

520 E Tulare Ave
Visalia, CA 93292-3629

Mailing address

520 E Tulare Ave
Visalia, CA 93292-3629
Phone (559) 623-0900

Other practice location 1

162 E Carson St
Colusa, CA 95932-2880
Phone (530) 458-0520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20241104001994 CA Practitioner - Clinical Social Worker 2769915388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of TulareGroup PAC ID 1456264555, 32 clinicians

Practice addresses (Care Compare)

520 E Tulare Ave
Visalia, CA 93292-3629
Phone (559) 623-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121708CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Tulare Current Accepting new patients
County of Tulare CurrentSince Aug 17, 2024 Accepting new patients
County of Tulare CurrentSince Aug 17, 2024 Accepting new patients

Locations

1055 W Henderson Ave
Porterville, CA 93257
Phone (559) 788-1200

520 E Tulare Ave
Visalia, CA 93292

5957 S Mooney Blvd
Visalia, CA 93277
Phone (559) 624-8000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1053891978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E TULARE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923629",
            "telephone_number": "559-623-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E TULARE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923629",
            "telephone_number": "559-623-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "162 E Carson St",
            "address_purpose": "LOCATION",
            "city": "Colusa",
            "state": "CA",
            "postal_code": "959322880",
            "country_code": "US",
            "telephone_number": "530-458-0520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREY",
        "first_name": "SHARISSA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.