Provider Demographics
NPI:1114413796
Name:GREGORY, LAURIE ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:GREGORY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 TEMI RD
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1225
Mailing Address - Country:US
Mailing Address - Phone:508-212-0552
Mailing Address - Fax:
Practice Address - Street 1:36 TEMI RD
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1225
Practice Address - Country:US
Practice Address - Phone:508-212-0552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health