Provider Demographics
NPI:1619079910
Name:SHUGAR, GREGORY J (LPA)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:J
Last Name:SHUGAR
Suffix:
Gender:M
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GOVERNMENT AVE SW
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-2954
Mailing Address - Country:US
Mailing Address - Phone:828-267-1740
Mailing Address - Fax:828-267-1746
Practice Address - Street 1:201 GOVERNMENT AVE SW
Practice Address - Street 2:SUITE 305
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2954
Practice Address - Country:US
Practice Address - Phone:828-267-1740
Practice Address - Fax:828-267-1746
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1198103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107140Medicaid