Individual provider · Type 1 NPI

Gregory Thackston

Mental Health Counselor · Athens, AL

NPI number 1780919050 Active

Practice location

1307 E Elm St
Athens, AL 35611-5318

Call (256) 232-3661 Map

Fax (256) 341-0747

Mailing address

1316 Somerville Rd SE, Suite 1
Decatur, AL 35601-4305

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1780919050

Gregory Thackston's National Provider Identifier is 1780919050, issued on Oct 5, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Athens, AL. The record was last updated on Jan 21, 2016.