Individual
JENNIFER BROOKE GREGORY-LYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
1925 N BRIDGE ST STE 101, ELKIN, NC 28621-2105
(368) 357-3373
(336) 835-7301
Mailing address
PO BOX 1490, BOONE, NC 28607-1490
(828) 262-3886
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7499
NC
101YP2500X
Professional Counselor
7499
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164756045
—
NC
Enumeration date
09/25/2009
Last updated
02/24/2023
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