Amy C Gray, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5073 Issued in KS

Practice address

407 S Clairborne Rd Ste 104
Olathe, KS 66062-1744

Phone

(913) 730-3661

Fax

(913) 768-1944

NPI assigned

Aug 8, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1154846467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S CLAIRBORNE RD STE 2",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621774",
            "telephone_number": "913-730-3661",
            "fax_number": "913-768-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S CLAIRBORNE RD STE 104",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621744",
            "telephone_number": "913-730-3661",
            "fax_number": "913-768-1944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5123 Birch St",
            "address_purpose": "LOCATION",
            "city": "Roeland Park",
            "state": "KS",
            "postal_code": "662052116",
            "country_code": "US",
            "telephone_number": "913-742-1368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "AMY",
        "middle_name": "C",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9411",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "5073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201164920",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Olathe, KS
• Providers in Olathe, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.