Provider Demographics
NPI:1750968475
Name:DANCY, GREGARY (LCMHCA)
Entity type:Individual
Prefix:PROF
First Name:GREGARY
Middle Name:
Last Name:DANCY
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 ROCKGLEN WAY APT 706
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5687
Mailing Address - Country:US
Mailing Address - Phone:917-554-7810
Mailing Address - Fax:
Practice Address - Street 1:6630 ROCKGLEN WAY APT 706
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5687
Practice Address - Country:US
Practice Address - Phone:917-554-7810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-27
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YS0200X101YS0200X
NC101YM0800X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool