Active NPI
Sharaye Gilmore, LCSW
- Clinical Social Worker
- Sikeston, MO
National Provider Identifier
1992212153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2015027866
- Practice address
- 135 Plaza Dr Suite 102
Sikeston, MO 63801 - Phone
- (573) 472-6010
- NPI assigned
- Jan 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2015027866 | MO | Primary |
Addresses
Primary practice location
135 Plaza Dr Suite 102
Sikeston, MO 63801
Mailing address
1008 N Main St
Sikeston, MO 63801
Phone (573) 472-7518
Other names 1
- Sharaye Grandberry
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015027866 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1992212153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 N MAIN ST",
"city": "SIKESTON",
"state": "MO",
"postal_code": "63801",
"telephone_number": "573-472-7518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 PLAZA DR SUITE 102",
"city": "SIKESTON",
"state": "MO",
"postal_code": "63801",
"telephone_number": "573-472-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMORE",
"first_name": "SHARAYE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-09",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2015027866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHARAYE",
"last_name": "GRANDBERRY",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sikeston, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.