Madeline Marie Gray, LMSW
Individual provider Active NPI Clinical Social Worker · Southaven, MS
NPI 1649005265 · NPPES record last updated Mar 20, 2025
Key facts
- NPI
- 1649005265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- M11215 (MS)
- Practice address
- 8626 Airways Blvd
Southaven, MS 38671-2603 - Phone
- (662) 772-5937
- Fax
- (662) 772-5940
- NPI assigned
- Sep 4, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Desoto Family Counseling Center PLLC
Practice addresses (Care Compare)
8626 Airways Blvd
Southaven, MS 38671-2603
Phone (662) 772-5937
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250506002709 | MS | Practitioner - Clinical Social Worker | 3375060064 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desoto Family Counseling Center PLLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | M11215 | MS | Yes |
Addresses
Primary practice location
8626 Airways Blvd
Southaven, MS 38671-2603
Mailing address
8626 Airways Blvd
Southaven, MS 38671-2603
Phone (662) 772-5937
Other names
- Madeline Marie Jones
Other providers in Southaven, MS
- Javel Granados
- Mary Grant
- Katherine Rivers Graves
- Madeleine Kayne Graves
- Keshell Antron Gray
- Wesley Allen Gray
- Allison Green
- Latonya Turner Green
- Greenbrook Physician Services, LLC
- Olivia Sanderson Gregory
All providers in Southaven, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.