Active NPI
Michelle Rose Clemens-Gray, MSW
- Clinical Social Worker
- Traverse City, MI
National Provider Identifier
1669586277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801070275
- Practice address
- 1213 W Front St
Traverse City, MI 49684-2317 - Phone
- (231) 935-0574
- Fax
- (231) 935-0387
- NPI assigned
- Aug 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 6801070275 | MI | Primary |
Addresses
Primary practice location
1213 W Front St
Traverse City, MI 49684-2317
Mailing address
1213 W Front St
Traverse City, MI 49684-2317
Phone (231) 935-0574
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801070275 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shelly Clemens-Gray, LMSW, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191196800000",
"number": "1669586277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 W FRONT ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842317",
"telephone_number": "231-935-0574",
"fax_number": "231-935-0387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 W FRONT ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842317",
"telephone_number": "231-935-0574",
"fax_number": "231-935-0387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENS-GRAY",
"first_name": "MICHELLE",
"middle_name": "ROSE",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801070275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.