Individual provider Active NPI

Annie Gray-Dalton, LCSW

  • Clinical Social Worker
  • Calhoun, KY
National Provider Identifier
1922433291
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3795 Issued in KY
Practice address
180 Main St
Calhoun, KY 42327
Phone
(270) 273-3050
Fax
(270) 273-3052
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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 3795 KY Primary

Addresses

Primary practice location

180 Main St
Calhoun, KY 42327

Mailing address

PO Box 654
180 Main St
Calhoun, KY 42327-0654
Phone (270) 273-3050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20131105000654 KY Practitioner - Clinical Social Worker 6507091253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

180 Main St
Calhoun, KY 42327-2151
Phone (270) 270-3050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3795KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gray Counseling Services PLLC Clinical CurrentSince Aug 4, 2015 Accepting new patients

Locations

180 Main St
Calhoun, KY 42327
Phone (270) 270-3050

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": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1922433291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 654",
            "address_2": "180 MAIN ST",
            "city": "CALHOUN",
            "state": "KY",
            "postal_code": "423270654",
            "telephone_number": "270-273-3050",
            "fax_number": "270-273-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MAIN ST",
            "city": "CALHOUN",
            "state": "KY",
            "postal_code": "42327",
            "telephone_number": "270-273-3050",
            "fax_number": "270-273-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY-DALTON",
        "first_name": "ANNIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, KY

Sources for this page

Verify at the official NPI Registry.