Healthcare Provider Details
I. General information
NPI: 1538565700
Provider Name (Legal Business Name): BRIANNA DEGREGORY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/14/2014
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
161 CAREY RD
QUEENSBURY NY
12804-7821
US
IV. Provider business mailing address
9 CAREY RD
QUEENSBURY NY
12804-7880
US
V. Phone/Fax
- Phone: 518-824-8610
- Fax: 518-824-2390
- Phone: 518-761-0300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 086543 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: