MEDICARE: MR. SEAN GREGORY M.S., PLPC

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	11275	LA

General Provider Information

NPI Number	:	1467384339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEAN GREGORY M.S., PLPC

Provider Business Mailing Address
First Line	:	108 PICCADILLY CIR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-7124
Country	:	US
Telephone Number	:	318-868-8767
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 PICCADILLY CIR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-7124
Country	:	US
Telephone Number	:	318-868-8767
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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