Individual
JUSTIN RICHARD MACGREGOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
911-913 STATE STREET, STATE STREET COUNSELING SERVICES, NEW HAVEN, CT 06511-3926
(203) 503-3660
(203) 503-3562
Mailing address
400 COLUMBUS AVENUE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3000
(203) 503-6515
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
4276
CT
Other
Enumeration date
06/08/2016
Last updated
07/31/2020
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