Jennifer Gregory, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

62622 Issued in TX

Practice address

3334 SSW Loop 323 Ste 107
Tyler, TX 75701-9237

Phone

(903) 330-1536

Fax

(903) 470-7328

NPI assigned

Nov 30, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Learning About Family

  • Clinical Social Worker
  • Tyler, TX
  • NPI 1689388860
  NPD

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1295339216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 SSW LOOP 323 STE 107",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019237",
            "telephone_number": "903-330-1536",
            "fax_number": "903-470-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 SSW LOOP 323 STE 107",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019237",
            "telephone_number": "903-330-1536",
            "fax_number": "903-470-7328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Oak St",
            "address_purpose": "LOCATION",
            "city": "Bullard",
            "state": "TX",
            "postal_code": "757575033",
            "country_code": "US",
            "telephone_number": "903-216-7012",
            "fax_number": "903-630-5305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "62622",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Greenberg, M.D.
• Matthew S Greene, ACNP
• Stephen Greene
• Marek Travis Greer, MD
• Morgan Faye Greer
• Shaderica Gregory
• Stacy Laine Gregory, ACNP
• Thomas F. Gregory, M.D.
• Adam Grer, LAT
• Katie Gresham

• Clinical Social Worker in Tyler, TX
• Providers in Tyler, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.