Provider Demographics
NPI:1871832717
Name:TREGRE, GLENN MICHAEL JR (LPC)
Entity type:Individual
Prefix:MR
First Name:GLENN
Middle Name:MICHAEL
Last Name:TREGRE
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3594 KENMORE DR
Mailing Address - Street 2:
Mailing Address - City:PAULINA
Mailing Address - State:LA
Mailing Address - Zip Code:70763-2312
Mailing Address - Country:US
Mailing Address - Phone:504-253-1278
Mailing Address - Fax:
Practice Address - Street 1:3520 GENERAL DEGAULLE DR
Practice Address - Street 2:SUITE 4070
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6757
Practice Address - Country:US
Practice Address - Phone:504-363-7449
Practice Address - Fax:504-363-7077
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA3864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional