Provider Demographics
NPI:1578784310
Name:GREGORY, SARA ELIZABETH (PHD LPC RNCNS MLAP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:GREGORY
Suffix:
Gender:F
Credentials:PHD LPC RNCNS MLAP
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:C
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD LPC RNCNS MLAP
Mailing Address - Street 1:6237 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094
Mailing Address - Country:US
Mailing Address - Phone:205-699-4929
Mailing Address - Fax:
Practice Address - Street 1:TWO METROPLEX DRIVE
Practice Address - Street 2:SUITE 500
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-443-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL086MLAP101YA0400X
AL1838101YP2500X
AL1025687163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered163W00000XNursing Service ProvidersRegistered Nurse