Jacquetta Denise Gregory, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P006648 Issued in NC

Practice address

1023 US Highway 17 S
Elizabeth City, NC 27909-9070

Phone

(252) 334-1536

Fax

(252) 334-1598

NPI assigned

Jul 12, 2012

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1396000535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1408",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279061408",
            "telephone_number": "252-334-1536",
            "fax_number": "252-334-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 US HIGHWAY 17 S",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099070",
            "telephone_number": "252-334-1536",
            "fax_number": "252-334-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JACQUETTA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P006648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wyconda Denise Gray, LCSW
• Taylor Balir Green, PHARMD
• Chelsea Elizabeth Greene, MASTERS DEGREE PSYCH
• Kinisha Greene
• Sharon Lizbeth Greene
• Daria Lenoria Robinson Griffis, LCSW-A, ASW
• Kara Jordan Grimstead, C-SLPA
• Jill Elizabeth Grutza, PHARM.D.
• Stephen Michael Guy, PHARMD
• H.E.a.L. Helping Everyone Achieve Life Skills Community Center

• Clinical Social Worker in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.