Gray Jessiman, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851119812 Issued in MI

Practice address

23100 Jefferson Ave
Saint Clair Shores, MI 48080-2756

Phone

(586) 335-2006

NPI assigned

May 6, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1124764873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 TOURAINE RD",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363363",
            "telephone_number": "720-539-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 JEFFERSON AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802756",
            "telephone_number": "586-335-2006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "294 Touraine Rd",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe Farms",
            "state": "MI",
            "postal_code": "482363363",
            "country_code": "US",
            "telephone_number": "720-539-4999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESSIMAN",
        "first_name": "GRAY",
        "name_prefix": "Ms.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851119812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward S. Jeffries, M.D.
• Jehan Wakeem DDS PLLC
• Devon Eileen Jennings, PA
• Melissa Jennings, M.D.
• Michael D Jennings, DENTIST
• Hanna Jetel, RD
• Jacob Jewell, FNP-C
• Hannah Emily Ranieri Jezak
• Jo Anne Levitan MD PC
• Joel L Pelavin MD PC

• All providers in Saint Clair Shores, MI
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.