Provider Demographics
NPI:1902933708
Name:GREGG, MARC ALAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:ALAN
Last Name:GREGG
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1800 S WASHINGTON ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79102-2610
Mailing Address - Country:US
Mailing Address - Phone:806-379-8282
Mailing Address - Fax:806-379-8278
Practice Address - Street 1:1800 S WASHINGTON ST
Practice Address - Street 2:SUITE 204
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-2610
Practice Address - Country:US
Practice Address - Phone:806-379-8282
Practice Address - Fax:806-379-8278
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX19721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional