Provider Demographics
NPI:1790826964
Name:GREGORY, MARIA EUTERPE (LPC, ART-BC,CGP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:EUTERPE
Last Name:GREGORY
Suffix:
Gender:F
Credentials:LPC, ART-BC,CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1905
Mailing Address - Country:US
Mailing Address - Phone:610-299-1606
Mailing Address - Fax:484-461-8787
Practice Address - Street 1:19 W STEWART AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-1905
Practice Address - Country:US
Practice Address - Phone:610-299-1606
Practice Address - Fax:484-461-8787
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101441254Medicaid