Individual provider Active NPI

Jill Marie Gracely, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1912406281
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
59555 Issued in TX
Practice address
3224 Ella Lee LN
Houston, TX 77019-5924
Phone
(832) 630-9661
Fax
(832) 630-9661
NPI assigned
Feb 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 59555 TX Primary

Addresses

Primary practice location

3224 Ella Lee LN
Houston, TX 77019-5924

Mailing address

3224 Ella Lee LN
Houston, TX 77019-5924
Phone (832) 630-9661

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

NPI Registry JSON

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1912406281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 ELLA LEE LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770195924",
            "telephone_number": "832-630-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 ELLA LEE LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770195924",
            "telephone_number": "832-630-9661",
            "fax_number": "832-630-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACELY",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.