Provider Demographics
NPI:1326726100
Name:FORTUNE, GREGORY (LPC, LMHC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:FORTUNE
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 SW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-6220
Mailing Address - Country:US
Mailing Address - Phone:954-518-3281
Mailing Address - Fax:
Practice Address - Street 1:1431 SW 9TH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-6220
Practice Address - Country:US
Practice Address - Phone:954-518-3281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00853400101YM0800X
FLMH24273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health