Provider Demographics
NPI:1144288770
Name:GREGORY, ANNE R (LCSW)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:R
Last Name:GREGORY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 REEDSDALE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233
Mailing Address - Country:US
Mailing Address - Phone:412-323-8026
Mailing Address - Fax:412-323-4507
Practice Address - Street 1:SOUTH 9TH ST CENTER
Practice Address - Street 2:330 SOUTH 9TH ST
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203
Practice Address - Country:US
Practice Address - Phone:412-488-4040
Practice Address - Fax:412-488-4932
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0121911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA180556OtherHIGHMARK
PA019193Medicare ID - Type Unspecified
S64277Medicare UPIN