Individual provider Active NPI

Summer Smith Gragg, MSW

  • Clinical Social Worker
  • Fort Pierce, FL
National Provider Identifier
1295443760
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW17681 Issued in FL
Practice address
2222 Colonial Rd Ste 100
Fort Pierce, FL 34950-5309
Phone
(772) 489-4726
NPI assigned
Nov 14, 2022
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW17681 FL Primary

Addresses

Primary practice location

2222 Colonial Rd Ste 100
Fort Pierce, FL 34950-5309

Mailing address

2222 Colonial Rd Ste 100
Fort Pierce, FL 34950-5309
Phone (772) 489-4726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW17681FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Access Counseling & Supportive Services, LLC Mental Health CurrentSince Jan 23, 2025 Accepting new patients
Legacy Behavioral Health Center Inc PastSince Nov 1, 2022 Accepting new patients
Legacy Behavioral Health Center Inc Multi-Specialty PastSince Nov 1, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1295443760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 COLONIAL RD STE 100",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349505309",
            "telephone_number": "772-489-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 COLONIAL RD STE 100",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349505309",
            "telephone_number": "772-489-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAGG",
        "first_name": "SUMMER",
        "middle_name": "SMITH",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW17681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.