Healthcare Provider Details

I. General information

NPI: 1265926117
Provider Name (Legal Business Name): TESA D GREGOIRE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TESA GREGOIRE LPCC

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 E 185TH ST
CLEVELAND OH
44119-2174
US

IV. Provider business mailing address

780 E 185TH ST
CLEVELAND OH
44119-2174
US

V. Phone/Fax

Practice location:
  • Phone: 216-681-9264
  • Fax:
Mailing address:
  • Phone: 216-681-9264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.2606881
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: