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Individual
VIRGIL LEE GREGORY JR.
Active
Individual
VIRGIL LEE GREGORY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW LSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001166A
IN
104100000X
Social Worker
33004885A
IN
1041C0700X
Clinical Social Worker
Primary
34006474A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530
—
IN
Enumeration date
05/17/2011
Last updated
04/12/2018
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