Provider Demographics
NPI:1265177687
Name:GREGORY, DENNIS FRANKLIN (LMFT)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:FRANKLIN
Last Name:GREGORY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7298 HIGHWAY 18 W
Mailing Address - Street 2:
Mailing Address - City:MENDENHALL
Mailing Address - State:MS
Mailing Address - Zip Code:39114-9206
Mailing Address - Country:US
Mailing Address - Phone:662-392-1035
Mailing Address - Fax:
Practice Address - Street 1:210 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2312
Practice Address - Country:US
Practice Address - Phone:662-392-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-0064106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist