Individual provider Active NPI

Justina Gray

  • Social Worker
  • Waldorf, MD
National Provider Identifier
1861382145
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
32617 Issued in MD
Practice address
3418 Milstead CT
Waldorf, MD 20602-1713
Phone
(240) 779-6589
NPI assigned
Jul 8, 2025
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 32617 MD Primary

Addresses

Primary practice location

3418 Milstead CT
Waldorf, MD 20602-1713

Mailing address

3418 Milstead CT
Waldorf, MD 20602-1713
Phone (240) 779-6589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20250909002036 MD Practitioner - Mental Health Counselor 5496257214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecting the Pieces, Mental Health Solutions LLCGroup PAC ID 8022547926, 3 clinicians

Practice addresses (Care Compare)

2670 Crain Hwy
Suite 510
Waldorf, MD 20601-2819
Phone (301) 778-1335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32617MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connecting the Pieces ; Mental Health Solutions, LLC CurrentSince Jul 14, 2025 Accepting new patients

Locations

2670 Crain Hwy
Ste 510
Waldorf, MD 20601
Phone (240) 416-6836

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1861382145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 MILSTEAD CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021713",
            "telephone_number": "240-779-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 MILSTEAD CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021713",
            "telephone_number": "240-779-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JUSTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "32617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.