Provider Demographics
NPI:1497202352
Name:PHIPPS, GREGORY STEVEN (LPCA)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:STEVEN
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 W CONE BLVD STE 234B
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4062
Mailing Address - Country:US
Mailing Address - Phone:336-392-6827
Mailing Address - Fax:
Practice Address - Street 1:2311 W CONE BLVD STE 234B
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4062
Practice Address - Country:US
Practice Address - Phone:336-392-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health