Provider Demographics
NPI:1497569982
Name:STORY, REAGAN KENINGTON
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:KENINGTON
Last Name:STORY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 KING ST APT 12
Mailing Address - Street 2:
Mailing Address - City:MONTEVALLO
Mailing Address - State:AL
Mailing Address - Zip Code:35115-3595
Mailing Address - Country:US
Mailing Address - Phone:334-419-9301
Mailing Address - Fax:
Practice Address - Street 1:1150 KING ST APT 12
Practice Address - Street 2:
Practice Address - City:MONTEVALLO
Practice Address - State:AL
Practice Address - Zip Code:35115-3595
Practice Address - Country:US
Practice Address - Phone:334-419-9301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker