Active NPI
Eric S. Gray, LCSWC
- Clinical Social Worker
- Berlin, MD
National Provider Identifier
1598893315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11776
- Practice address
- 9730 Healthway Drive
Berlin Health Center
Berlin, MD 21811 - Phone
- (410) 629-0164
- Fax
- (410) 629-0185
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11776 | MD | Primary |
Addresses
Primary practice location
9730 Healthway Drive
Berlin Health Center
Berlin, MD 21811
Mailing address
PO Box 618
Hebron, MD 21830-0618
Phone (410) 376-3517
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11776 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598893315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 618",
"city": "HEBRON",
"state": "MD",
"postal_code": "218300618",
"telephone_number": "410-376-3517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9730 HEALTHWAY DRIVE",
"address_2": "BERLIN HEALTH CENTER",
"city": "BERLIN",
"state": "MD",
"postal_code": "21811",
"telephone_number": "410-629-0164",
"fax_number": "410-629-0185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "ERIC",
"middle_name": "S.",
"credential": "LCSWC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "11776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.