Provider Demographics
NPI:1629425657
Name:LAMONT, GREGORY M (LPC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:M
Last Name:LAMONT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 SW NANCY WAY
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3234
Mailing Address - Country:US
Mailing Address - Phone:541-617-0377
Mailing Address - Fax:541-617-0377
Practice Address - Street 1:1569 SW NANCY WAY
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3234
Practice Address - Country:US
Practice Address - Phone:541-617-0377
Practice Address - Fax:541-617-0377
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC5442101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health