Alicia Marie Gregory, LMFT
Individual provider Active NPI Marriage & Family Therapist · Gray, GA
NPI 1760602007 · NPPES record last updated Dec 4, 2009
Key facts
- NPI
- 1760602007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFT001039 (GA)
- Practice address
- 111 Dolly St
Gray, GA 31032-5307 - Phone
- (478) 491-1991
- Fax
- (478) 986-2337
- NPI assigned
- Apr 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT001039 | GA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT001039 | GA | Yes |
Addresses
Primary practice location
111 Dolly St
Gray, GA 31032-5307
Mailing address
276 Katherine Dr
Gray, GA 31032-3865
Phone (478) 491-1991
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 173019348A | Medicaid | GA |
Other providers in Gray, GA
- Kevin Grant
- Gray Dental Associates
- Gray Dental Associates, P.C.
- Gray Drug Co Inc
- Gray Family Health LLC
- Thomas Griffin III
- Andre Guinan
- Sean Hawkins
- Hannah Grace Henning
- Calita Suzanne Hill
All providers in Gray, GA · Marriage & Family Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.