Provider Demographics
NPI:1437418837
Name:GREGORSKI, PAMELA J (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:GREGORSKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SARANAC
Mailing Address - State:MI
Mailing Address - Zip Code:48881-5102
Mailing Address - Country:US
Mailing Address - Phone:616-642-6466
Mailing Address - Fax:
Practice Address - Street 1:92 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SARANAC
Practice Address - State:MI
Practice Address - Zip Code:48881-5102
Practice Address - Country:US
Practice Address - Phone:616-642-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010862701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical