Provider Demographics
NPI:1679126957
Name:GREGSON, TRUDY (LPC)
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:
Last Name:GREGSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 FLOURTOWN AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7969
Mailing Address - Country:US
Mailing Address - Phone:267-652-1732
Mailing Address - Fax:
Practice Address - Street 1:8200 FLOURTOWN AVENUE
Practice Address - Street 2:SUITE 1C
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038
Practice Address - Country:US
Practice Address - Phone:267-652-1732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011236101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional