Provider Demographics
NPI:1639445059
Name:MCGREGOR, ELIZABETH KELLIE (LMFT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KELLIE
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 NOTRE DAME BLVD STE 370-114
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-7161
Mailing Address - Country:US
Mailing Address - Phone:530-491-4374
Mailing Address - Fax:530-267-7049
Practice Address - Street 1:2260 SAINT GEORGE LN STE 6
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-491-4374
Practice Address - Fax:530-267-7049
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225C00000X
CA88549106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor