Individual provider Active NPI

Justin Danta Gravely-Strayhorn, LCSW

  • Clinical Social Worker
  • Chesapeake, VA
National Provider Identifier
1225901986
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904019239 Issued in VA
Practice address
615 Dupree LN
Chesapeake, VA 23324-1475
Phone
(804) 299-8710
NPI assigned
Sep 27, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 0904019239 VA Primary

Addresses

Primary practice location

615 Dupree LN
Chesapeake, VA 23324-1475

Mailing address

615 Dupree LN
Chesapeake, VA 23324-1475
Phone (804) 299-8710

Other practice location 1

620 John Paul Jones Cir
Portsmouth, VA 23708-2197
Phone (757) 953-8380

Other practice location 2

1035 Nider Blvd
Virginia Beach, VA 23459-8701
Phone (757) 953-8380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251108000518 VA Practitioner - Mental Health Counselor 6608366422 Reassigns benefits to 1 organization
I20260429000600 VA Practitioner - Clinical Social Worker 6608366422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

224 Great Bridge Blvd
Chesapeake, VA 23320-3904

7025 Harbour View Blvd
Suite 119
Suffolk, VA 23435-2761

7025 Harbour View Blvd
Suite 119
Suffolk, VA 23435-2762

7025 Harbour View Dr
Suite 119
Suffolk, VA 23435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904019239VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Western Tidewater Community Mental Single Specialty CurrentSince Oct 6, 2025 Accepting new patients

Locations

200 E 2nd Ave
Franklin, VA 23851
Phone (757) 562-2208

1913 S Church St
Ste 2
Smithfield, VA 23430
Phone (757) 357-7458

1000 Commercial Ln
Suffolk, VA 23434
Phone (757) 925-2484

7025 Harbour View Blvd
Ste 119
Suffolk, VA 23435
Phone (757) 670-7471

Organizations & group practices 2

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": "1758931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1225901986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 DUPREE LN",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233241475",
            "telephone_number": "804-299-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 DUPREE LN",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233241475",
            "telephone_number": "804-299-8710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082197",
            "country_code": "US",
            "telephone_number": "757-953-8380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Nider Blvd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234598701",
            "country_code": "US",
            "telephone_number": "757-953-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVELY-STRAYHORN",
        "first_name": "JUSTIN",
        "middle_name": "DANTA",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-27",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904019239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.