Deborah Jean Gregg, MA LICENSED PSYCHOLO

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS007124L Issued in PA

Practice address

10744 St Hwy
East Side Knolls #18
Conneaut Lake, PA 16316-3320

Phone

(814) 382-3949

Fax

(814) 382-1458

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124114186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10744 ST HWY",
            "address_2": "EAST SIDE KNOLLS #18",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163163320",
            "telephone_number": "814-382-3949",
            "fax_number": "814-382-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10744 ST HWY",
            "address_2": "EAST SIDE KNOLLS #18",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163163320",
            "telephone_number": "814-382-3949",
            "fax_number": "814-382-1458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "MA LICENSED PSYCHOLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS007124L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Thomas Foulk, DMD
• Thomas Carl Fox, DMD
• Thomas Gilbert, PT, DPT
• Hannah Gill, CRNP
• Kelsey Greathouse, MA, CCC-SLP
• Jon Hank, OTR/L
• Kayla Rae Heagy, MOT, OTR/L
• Christine R Herman, LPC
• Maria L Hildebran
• Karima Mental Health Services LLC

• Psychologist in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.