Christine Ketterer Gray, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904007408 Issued in VA

Practice address

2305 N Parham Rd Ste 3
Richmond, VA 23229-3156

Phone

(804) 270-1124

Fax

(804) 270-2090

NPI assigned

Apr 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dominion Behavioral HealthcareGroup PAC ID 6709803570, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dominion Behavioral Healthcare

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1043262215
  Medicare reassignment Care Compare group NPD
• Dominion Behavioral Healthcare

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1427075449
  NPD

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1740787126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 LEDGE CIR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595398",
            "telephone_number": "804-727-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 N PARHAM RD STE 3",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293156",
            "telephone_number": "804-270-1124",
            "fax_number": "804-270-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "CHRISTINE",
        "middle_name": "KETTERER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gray MD Psychiatry, LLC
• Adam McCoy Gray, M.D.
• Allison Tucker Gray, M.D.
• Cheryl Ann Gray, LCSW
• Christina Gray, FNP-BC
• Deeana Gray
• Erica Gray, CMT
• Fred Anderson Gray Jr., CSAC
• Hayley Gray
• Herbert Lorenza Gray III

• Clinical Social Worker in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.