Provider Demographics
NPI:1629013891
Name:DELANEY, GREGORY LYNN (RSW)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:LYNN
Last Name:DELANEY
Suffix:
Gender:M
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32841 AUGUSTA CT
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-6300
Mailing Address - Country:US
Mailing Address - Phone:313-516-5554
Mailing Address - Fax:
Practice Address - Street 1:32841 AUGUSTA CT
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-6300
Practice Address - Country:US
Practice Address - Phone:313-516-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL9060251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical