Provider Demographics
NPI:1467760785
Name:GREGG, CHEYENNE DARRETT (LCMHC)
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:DARRETT
Last Name:GREGG
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6600
Mailing Address - Country:US
Mailing Address - Phone:336-274-1538
Mailing Address - Fax:
Practice Address - Street 1:8110 SUTTONVIEW DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-5186
Practice Address - Country:US
Practice Address - Phone:704-936-7156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional