Male or Other

Gregory Ingram LCSW

Clinical Social Worker in Roselle, NJ(View on Map)

Full Name

Gregory Ingram LCSW

NPI Number

1427488824

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/21/2013

Specialties

(Taxonomies)

Code

1041C0700X
1041S0200X

Primary Taxonomy

Yes
No

Licenses

State

New Jersey
New Jersey

License Number

44SC05532900
00273388

Contact
Information

Purpose

Mailing
Location

Address

210 E 2ND AVE
120 HALCYON PL

City

Roselle
Roselle

State

NJ
NJ

Postal Code

07203-1306
07203-1512

Country

US
US

Telephone Number

N/A
(908) 422-5340

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/21/2013

Provider Address

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Male or Other

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