Provider Demographics
NPI:1427358217
Name:WEEKS, GREGORY P (LPCC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:P
Last Name:WEEKS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 DEVA LN
Mailing Address - Street 2:
Mailing Address - City:GLORIETA
Mailing Address - State:NM
Mailing Address - Zip Code:87535-7067
Mailing Address - Country:US
Mailing Address - Phone:575-776-4354
Mailing Address - Fax:
Practice Address - Street 1:1223 S SAINT FRANCIS DR STE E
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4053
Practice Address - Country:US
Practice Address - Phone:505-982-8098
Practice Address - Fax:505-982-3948
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0182361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health