Individual provider Active NPI

Denise Gray, PHD, LCSW, BCC

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1396047312
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149010034 Issued in IL
Practice address
916 W Owens Ave
Las Vegas, NV 89106-2516
Phone
(702) 791-9000
Fax
(702) 224-6091
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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 149010034 IL Primary

Addresses

Primary practice location

916 W Owens Ave
Las Vegas, NV 89106-2516

Mailing address

916 W Owens Ave
Las Vegas, NV 89106-2516
Phone (702) 791-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
149010034ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1396047312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 W OWENS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062516",
            "telephone_number": "702-791-9000",
            "fax_number": "702-224-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 W OWENS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062516",
            "telephone_number": "702-791-9000",
            "fax_number": "702-224-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW, BCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.