Provider Demographics
NPI:1063213247
Name:GRAY, MELISSA ANGELA (MSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANGELA
Last Name:GRAY
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 KING ARTHUR CT
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2206
Mailing Address - Country:US
Mailing Address - Phone:630-696-6948
Mailing Address - Fax:
Practice Address - Street 1:369 KING ARTHUR CT
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2206
Practice Address - Country:US
Practice Address - Phone:630-696-6948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical