Individual provider Active NPI

Gayla Graven

  • Clinical Social Worker
  • Springfield, MO
National Provider Identifier
1639665854
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2019038093 Issued in MO
Practice address
1147 E Walnut St
Springfield, MO 65806-2616
Phone
(417) 380-2001
NPI assigned
Jul 11, 2018
Last updated
May 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2024

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 2019038093 MO Primary

Addresses

Primary practice location

1147 E Walnut St
Springfield, MO 65806-2616

Mailing address

2052 N Missouri Ave
Springfield, MO 65803-1546
Phone (417) 380-2001

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1639665854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2052 N MISSOURI AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658031546",
            "telephone_number": "417-380-2001",
            "fax_number": "660-665-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 E WALNUT ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658062616",
            "telephone_number": "417-380-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVEN",
        "first_name": "GAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2024-05-18",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2019038093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.