Individual provider Active NPI

Michele Diane Gray, LCSW

  • Clinical Social Worker
  • Rockland, ME
National Provider Identifier
1508084047
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC4535 Issued in ME
Practice address
21 Limerock St
Room 217 & 219
Rockland, ME 04841-2977
Phone
(207) 596-6044
NPI assigned
Apr 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LC4535 ME Primary

Addresses

Primary practice location

21 Limerock St
Room 217 & 219
Rockland, ME 04841-2977

Mailing address

PO Box 383
Rockland, ME 04841-0383
Phone (207) 596-6044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20041028000172 ME Practitioner - Clinical Social Worker 2264494723 Practice locations: Rockland, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21 Limerock St
Rockland, ME 04841-2977
Phone (207) 596-6044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508084047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 383",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048410383",
            "telephone_number": "207-596-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 LIMEROCK ST",
            "address_2": "ROOM 217 & 219",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412977",
            "telephone_number": "207-596-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MICHELE",
        "middle_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockland, ME

Sources for this page

Verify at the official NPI Registry.