Individual provider Active NPI

Deedee Gregoire, LCSW

  • Clinical Social Worker
  • Galveston, TX
National Provider Identifier
1962478669
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19918 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555
Phone
(409) 772-2166
Fax
(409) 772-2663
NPI assigned
Feb 23, 2006
Last updated
May 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19918 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555

Mailing address

301 University Blvd
Galveston, TX 77555-1385
Phone (409) 772-2166

Other identifiers 5

IdentifierTypeStateIssuer
GREGO-0003OtherTXCOMPCARE
038924902MedicaidTX
316877OtherTXMHN
788951000OtherTXMAGELLAN
0016RKOtherTXBLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19918TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Center of Galveston County, Texas PastSince Jan 22, 2012 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1962478669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551385",
            "telephone_number": "409-772-2166",
            "fax_number": "409-772-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77555",
            "telephone_number": "409-772-2166",
            "fax_number": "409-772-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGOIRE",
        "first_name": "DEEDEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "19918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPCARE",
            "identifier": "GREGO-0003",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038924902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "316877",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "788951000",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0016RK",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.