Provider Demographics
NPI:1902913346
Name:MCGREGOR, MICHAEL MURRAY (LCSW LICSW LMFT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:MURRAY
Last Name:MCGREGOR
Suffix:
Gender:M
Credentials:LCSW LICSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6123 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-881-3700
Mailing Address - Fax:301-468-1862
Practice Address - Street 1:11B FIRST FIELD RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:301-990-6880
Practice Address - Fax:301-990-0257
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03962104100000X
DCLC301088104100000X
MDLCM085106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD235284OtherKAISER
MD41778302OtherBCBS OF MD
MD7851331OtherAETNA
DCA2840090OtherBCBS OF DC
008313J37Medicare ID - Type Unspecified