Active NPI
Dedrick Michelle Grady, MSW
- Social Worker
- Booneville, MS
National Provider Identifier
1578254348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 609 E Church St
Booneville, MS 38829-3711 - Phone
- (662) 728-2488
- NPI assigned
- May 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
609 E Church St
Booneville, MS 38829-3711
Mailing address
1867 Crane Ridge Dr Ste 150C
Jackson, MS 39216-4910
Phone (662) 372-2033
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1578254348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1867 CRANE RIDGE DR STE 150C",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164910",
"telephone_number": "662-372-2033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 E CHURCH ST",
"city": "BOONEVILLE",
"state": "MS",
"postal_code": "388293711",
"telephone_number": "662-728-2488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "DEDRICK",
"middle_name": "MICHELLE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-15",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Booneville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.