Provider Demographics
NPI:1952450678
Name:GREGSON, JEFFREY JAY (LPC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:JAY
Last Name:GREGSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:722 SHEPARD LN
Mailing Address - Street 2:#105
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-3845
Mailing Address - Country:US
Mailing Address - Phone:801-451-2623
Mailing Address - Fax:801-451-2623
Practice Address - Street 1:722 SHEPARD LN
Practice Address - Street 2:#105
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-3845
Practice Address - Country:US
Practice Address - Phone:801-451-2623
Practice Address - Fax:801-451-2623
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT373684-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional