Provider Demographics
NPI:1073797643
Name:GREGORY, MELISSA ERIN (MA MFT, LPC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ERIN
Last Name:GREGORY
Suffix:
Gender:F
Credentials:MA MFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806
Mailing Address - Country:US
Mailing Address - Phone:302-652-3948
Mailing Address - Fax:302-652-8297
Practice Address - Street 1:1213 DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806
Practice Address - Country:US
Practice Address - Phone:302-652-3948
Practice Address - Fax:302-652-8297
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2013-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000506101YM0800X
DCPRC14242101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health