NPIMap

Organization Active NPI

Shelly Clemens-Gray, LMSW, LLC

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1215041702
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801070275 Issued in MI
Legal business name
SHELLY CLEMENS-GRAY, LMSW, LLC
Practice address
1213 W Front St
Traverse City, MI 49684-2317
Phone
(231) 935-0386
Fax
(231) 935-0387
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michelle Clemens-Gray, MSWNPI 1669586277
Title
Owner
Phone
(231) 935-0574

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801070275 MI Primary

Addresses

Primary practice location

1213 W Front St
Traverse City, MI 49684-2317

Mailing address

1213 W Front St
Traverse City, MI 49684-2317
Phone (231) 935-0386

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215041702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842317",
            "telephone_number": "231-935-0386",
            "fax_number": "231-935-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842317",
            "telephone_number": "231-935-0386",
            "fax_number": "231-935-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLY CLEMENS-GRAY, LMSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLEMENS-GRAY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-935-0574",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801070275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.