Provider Demographics
NPI:1659388460
Name:GREGORY, SCOTT PAYSON (LMFT, ATR)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:PAYSON
Last Name:GREGORY
Suffix:
Gender:M
Credentials:LMFT, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 ELKTON DR STE 403
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8507
Mailing Address - Country:US
Mailing Address - Phone:719-574-6562
Mailing Address - Fax:719-570-0386
Practice Address - Street 1:1115 ELKTON DR STE 403
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8507
Practice Address - Country:US
Practice Address - Phone:719-574-6562
Practice Address - Fax:719-570-0386
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO181106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist