Cloye Anita Barnhart-Gray, LCSW

Individual provider Active NPI Clinical Social Worker · MC Kenzie, TN

NPI 1528059516 · NPPES record last updated Oct 26, 2015

Key facts

NPI
1528059516
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LSW0000004446 (TN)
Practice address
21205 Hyw 22
MC Kenzie, TN 38201-1649
Phone
(731) 352-1401
Fax
(731) 352-1402
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LSW0000004446TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Services of Jackson Clinical Past
since Feb 22, 2012
Accepting new patients
Behavioral Health and Wellness Past
since Jun 3, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSW0000004446 TN Yes

Addresses

Primary practice location

21205 Hyw 22
MC Kenzie, TN 38201-1649

Mailing address

21205 Hyw 22
MC Kenzie, TN 38201-1649
Phone (731) 352-1401

Other identifiers

IdentifierTypeStateIssuer
1507746MedicaidTN

Other providers in MC Kenzie, TN

All providers in MC Kenzie, TN · Clinical Social Worker in Tennessee

Sources for this page

Verify at the official NPI Registry.