Lettie Denise Gray, MSW,LCSW,LCAC,MAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3406620A Issued in IN

Practice address

2622 Lake Ave Ste 1
Fort Wayne, IN 46805-5410

Phone

(260) 299-3160

NPI assigned

Jun 10, 2021

Last updated

Jul 24, 2025By the provider in NPPES

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 IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lettie.gray.p1@direct.meridianhs.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Meridian Health Services Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muncie, IN
  • NPI 1992755490
  Medicare reassignment NPD
• Meridian Health Services Corp.

  • Federally Qualified Health Center (FQHC)
  • Montpelier, IN
  • NPI 1417838574
  NPD

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1821665514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 LAKE AVE STE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055410",
            "telephone_number": "260-299-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "LETTIE",
        "middle_name": "DENISE",
        "credential": "MSW,LCSW,LCAC,MAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "3406620A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas L Gray, MD
• Ganit Anna Gray, LCSW
• Kathleen Gray
• Kaylee Gray
• Lauren Teresa Gray, COTA
• Warren C Gray, BS
• Kelly Grayson
• Great Heights ABA Inc.
• Great Lakes Caring Hospice Nin, LLC (Elara Caring)
• Great Lakes Pediatric Surgeons, Inc.

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.