Sandra Jean Gray, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4554 Issued in TN

Practice address

500 Minton Hollow Rd
Elizabethton, TN 37643-7906

Phone

(423) 202-1969

Fax

(423) 373-1308

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sneedville, TN
  • NPI 1053475558
  NPD (past)
• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gray, TN
  • NPI 1720147408
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1508873944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376441108",
            "telephone_number": "423-202-1969",
            "fax_number": "423-373-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MINTON HOLLOW RD",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376437906",
            "telephone_number": "423-202-1969",
            "fax_number": "423-373-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SANDRA",
        "middle_name": "JEAN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3699237",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Denise Glass, NA2
• Peggy S. Gong, R.PH.
• Robert Roy Gorby Jr., D.C.
• Matthew Gouge, PHARMD
• Jennifer Lea Grady, LPC-MHSP
• John David Green, M.D.
• Heather Deanne Greene, FNP
• Jonathan Daniel Greenlee, PTA
• Montgomery A Greer, LPC, MHSP
• Rebekah Clare Greer, PT, DPT, NCS

• Clinical Social Worker in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.