Provider Demographics
NPI:1851059935
Name:GORE, GREGORY LANGSTON (LPC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:LANGSTON
Last Name:GORE
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 1:17103 PRESTON RD STE 288
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1372
Mailing Address - Country:US
Mailing Address - Phone:972-250-0498
Mailing Address - Fax:
Practice Address - Street 1:17103 PRESTON RD STE 288
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1372
Practice Address - Country:US
Practice Address - Phone:972-250-0498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16324101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health