Provider Demographics
NPI:1336941244
Name:J CREGO LCSW LLC
Entity type:Organization
Organization Name:J CREGO LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:CREGO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LADC
Authorized Official - Phone:203-768-9808
Mailing Address - Street 1:40 SUNRISE LN
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1466
Mailing Address - Country:US
Mailing Address - Phone:203-768-9808
Mailing Address - Fax:203-768-9808
Practice Address - Street 1:262 MARLBOROUGH ST STE 206
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1901
Practice Address - Country:US
Practice Address - Phone:203-768-9808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty