Provider Demographics
NPI:1740353713
Name:MACGREGOR, NANCY T (MA, ATR-BC, LPC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:T
Last Name:MACGREGOR
Suffix:
Gender:F
Credentials:MA, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 KENDALL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-1539
Mailing Address - Country:US
Mailing Address - Phone:856-854-5804
Mailing Address - Fax:
Practice Address - Street 1:739 S WHITE HORSE PIKE
Practice Address - Street 2:SUITE #8
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1659
Practice Address - Country:US
Practice Address - Phone:856-547-9200
Practice Address - Fax:856-547-9220
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00328500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health