Provider Demographics
NPI:1770001984
Name:GREGOR, LAURA MEGAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MEGAN
Last Name:GREGOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 EAST FAIRMOUNT AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801
Mailing Address - Country:US
Mailing Address - Phone:814-208-5665
Mailing Address - Fax:844-654-7369
Practice Address - Street 1:141 EAST FAIRMOUNT AVENUE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801
Practice Address - Country:US
Practice Address - Phone:814-208-5665
Practice Address - Fax:844-654-7369
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0212741041C0700X
PASW1344121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical