Provider Demographics
NPI:1376348409
Name:GOUYD, GREGG MATTHEWS II
Entity type:Individual
Prefix:MR
First Name:GREGG
Middle Name:MATTHEWS
Last Name:GOUYD
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10965 WINDS CROSSING DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-2400
Mailing Address - Country:US
Mailing Address - Phone:980-224-3295
Mailing Address - Fax:
Practice Address - Street 1:10965 WINDS CROSSING DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-2400
Practice Address - Country:US
Practice Address - Phone:980-224-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health