MEDICARE: JENNIFER MARIE GREGG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	37AC00952700	NJ

General Provider Information

NPI Number	:	1851233191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MARIE GREGG

Provider Business Mailing Address
First Line	:	921 PLEASANT VALLEY AVE # 322
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-1210
Country	:	US
Telephone Number	:	856-419-6611
Fax Number	:

Provider Business Practice Location Address
First Line	:	921 PLEASANT VALLEY AVE # 322
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-1210
Country	:	US
Telephone Number	:	856-419-6611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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