Provider Demographics
NPI:1245285790
Name:REGAN, MARGARET R (MS)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:REGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:9 FLOSSMORE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4043
Mailing Address - Country:US
Mailing Address - Phone:337-234-3874
Mailing Address - Fax:
Practice Address - Street 1:600 JEFFERSON ST
Practice Address - Street 2:SUITE 902
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6942
Practice Address - Country:US
Practice Address - Phone:337-993-0000
Practice Address - Fax:337-354-2410
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171101YA0400X
LA2244101YP2500X
LA37106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist