Individual provider Active NPI

Joanne Sullivan Gray, LCSW

  • Clinical Social Worker
  • Manasquan, NJ
National Provider Identifier
1679051007
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05942400 Issued in NJ
Practice address
200 Atlantic Ave
Manasquan, NJ 08736-1352
Phone
(609) 916-6445
NPI assigned
Jul 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL06397500 NJ
Clinical Social Worker 1041C0700X 44SC05942400 NJ Primary

Addresses

Primary practice location

200 Atlantic Ave
Manasquan, NJ 08736-1352

Mailing address

412 5TH Ave
Belmar, NJ 07719-2111
Phone (732) 681-8717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201019003310 NJ Practitioner - Clinical Social Worker 3971923699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Best Practices BhomGroup PAC ID 3072876994, 21 clinicians

Practice addresses (Care Compare)

81 Crooked Stick Rd
Jackson, NJ 08527-4032
Phone (609) 916-6402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06397500NJMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Best Practices Bhom Clinical CurrentSince Sep 3, 2021 Accepting new patients

Locations

200 Atlantic Ave
Ste G
Manasquan, NJ 08736
Phone (732) 592-9149

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": "1532736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1679051007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 5TH AVE",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077192111",
            "telephone_number": "732-681-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ATLANTIC AVE",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361352",
            "telephone_number": "609-916-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JOANNE",
        "middle_name": "SULLIVAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-28",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06397500",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05942400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manasquan, NJ

Sources for this page

Verify at the official NPI Registry.