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General NPI Number Information
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NPI Number | 1982878211
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Entity Type | Organization
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Legal Business Name | GREGG PSYCHOTHERAPY, PC
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 1092 LASKIN RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6362
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Country | US
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Telephone | 757-422-2408
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Fax | 757-422-2162
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Provider Business Mailing Address
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Address Line | 3419 VIRGINIA BEACH BLVD # 181
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4419
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Country | US
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Telephone | 757-422-2408
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Fax | 757-422-4162
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. SUZANNE GETZ GREGG
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Credential | PHD, LPC
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Telephone | 757-422-2408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701001580
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License Number State | VA
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