Individual provider Active NPI

Amy Gregor, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1679706907
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5950 Fairview Rd Ste 618
Charlotte, NC 28210-3113
Phone
(704) 457-8222
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C009767 NC
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

5950 Fairview Rd Ste 618
Charlotte, NC 28210-3113

Mailing address

5950 Fairview Rd Ste 618
Charlotte, NC 28210-3113
Phone (704) 457-8222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C009767NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Queen City Counseling & Consulting, PLLC Mental Health CurrentSince Jul 25, 2019 Accepting new patients

Locations

5950 Fairview Rd
Ste 150
Charlotte, NC 28210
Phone (704) 430-8595

5950 Fairview Rd
Ste 740
Charlotte, NC 28210
Phone (704) 457-8222

5950 Fairview Rd
Ste 618
Charlotte, NC 28210
Phone (704) 457-8222

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1679706907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 FAIRVIEW RD STE 618",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "704-457-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 FAIRVIEW RD STE 618",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "704-457-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGOR",
        "first_name": "AMY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C009767",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.