Basic Information
| Provider Information | |||||||||
| NPI: | 1477790467 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GREG M. SINGLETON, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14049 FM 757 | ||||||||
| Address2: | |||||||||
| City: | WINONA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757926034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035210151 | ||||||||
| FaxNumber: | 8882428720 | ||||||||
| Practice Location | |||||||||
| Address1: | 14049 FM 757 | ||||||||
| Address2: | |||||||||
| City: | WINONA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757926034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035210151 | ||||||||
| FaxNumber: | 8882428720 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2009 | ||||||||
| LastUpdateDate: | 01/13/2009 | ||||||||
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| AuthorizedOfficialLastName: | SINGLETON | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | MILAM | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9035210151 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 27743 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.