Individual provider · Type 1 NPI
Gregory Bruce Jack, LPC
Professional Counselor · Plainfield, CT
NPI number
1164517512
Active
Practice location
50 Academy Hill Road
Plainfield, CT 06374
Fax (860) 564-3025
Mailing address
50 Academy Hill Road, P.o. Box 201
Plainfield, CT 06374
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 000758 (CT) |
Professional Counselor: Definition to come...
Another provider at this address
Other professional counselor providers in Plainfield
About NPI 1164517512
Gregory Bruce Jack, LPC's National Provider Identifier is 1164517512, issued on Oct 3, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Plainfield, CT. The record was last updated on Nov 14, 2024.