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General NPI Number Information
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NPI Number | 1225801400
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Entity Type | Individual
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Provider Name | JANE M GRAY MSW, LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 17611 E US HIGHWAY 24
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City | INDEPENDENCE
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State | MO
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Zip | 64056-1853
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Country | US
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Telephone | 816-836-6350
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Fax |
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Provider Business Mailing Address
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Address Line | 2885 W BATTLEFIELD ST
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City | SPRINGFIELD
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State | MO
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Zip | 65807-3952
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Country | US
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Telephone | 417-761-5214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2020021683
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License Number State | MO
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