Provider Demographics
NPI:1538218144
Name:PRINCE, GREGORY A (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:PRINCE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9547 ELK MOUNTAIN CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-8883
Mailing Address - Country:US
Mailing Address - Phone:303-884-1346
Mailing Address - Fax:
Practice Address - Street 1:5941 MIDDLEFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7937
Practice Address - Country:US
Practice Address - Phone:303-853-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4459101YP2500X
COLPC.0004459101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional