Collette Carter Gregersen, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-6323 Issued in ID

Practice address

444 Hospital Way Ste 477
Pocatello, ID 83201-2744

Phone

(208) 233-7832

NPI assigned

Aug 15, 2017

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

Other names 1

• Collette Carter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gateway Counseling Incorporated

  • Community/Behavioral Health Agency
  • Pocatello, ID
  • NPI 1528366424
  NPD (past)
• Portneuf Valley Family Center

  • Professional Counselor
  • Pocatello, ID
  • NPI 1174629976
  NPD (past)

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1326564956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 HOSPITAL WAY STE 477",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012744",
            "telephone_number": "208-233-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 HOSPITAL WAY STE 477",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012744",
            "telephone_number": "208-233-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGERSEN",
        "first_name": "COLLETTE",
        "middle_name": "CARTER",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-6323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLETTE",
            "last_name": "CARTER",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel A Green
• Felicia Green, PHARMD
• Lindsay Dawn Green, SLP
• Michele Renee Green
• Tracy Jo Green, R.D.
• Gregory M. Ford, MD PLLC
• Matthew Gregson, PA-C
• Michael J Gregson, MD
• Griffin Anesthesia, LLC
• Brandon Griffin, DMD

• Professional Counselor in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.