Provider Demographics
NPI:1679249932
Name:NITZ, GREGORY PATRICK (LPC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:PATRICK
Last Name:NITZ
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 1:2240 HAMDEN CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5824
Mailing Address - Country:US
Mailing Address - Phone:972-251-3486
Mailing Address - Fax:
Practice Address - Street 1:7800 PRESTON RD STE 144
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3239
Practice Address - Country:US
Practice Address - Phone:469-647-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75428101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional