Individual provider Active NPI

Chika Gray, MSW, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1447599196
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
670 Prospect Ave
Hartford, CT 06105-4240
Phone
(860) 578-9088
Fax
(888) 294-8778
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 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 CT Primary

Addresses

Primary practice location

670 Prospect Ave
Hartford, CT 06105-4240

Mailing address

PO Box 1103
Glastonbury, CT 06033-6103
Phone (860) 578-9088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160601000331 CT Practitioner - Clinical Social Worker 8123318367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jun 7, 2022 Accepting new patients
State of Connecticut CurrentSince Jun 7, 2022 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

401 W Thames St
Bldg 301
Norwich, CT 06360
Phone (860) 859-4500

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": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1447599196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1103",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060336103",
            "telephone_number": "860-578-9088",
            "fax_number": "888-294-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PROSPECT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061054240",
            "telephone_number": "860-578-9088",
            "fax_number": "888-294-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CHIKA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.