Provider Demographics
NPI:1043714652
Name:SPRINGS, REGAN MARGARET
Entity type:Individual
Prefix:
First Name:REGAN
Middle Name:MARGARET
Last Name:SPRINGS
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 1:1402 KELLUM CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-5114
Mailing Address - Country:US
Mailing Address - Phone:704-560-8493
Mailing Address - Fax:910-213-3998
Practice Address - Street 1:2512 INDEPENDENCE BLVD STE 100-035
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2571
Practice Address - Country:US
Practice Address - Phone:910-338-3804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO115801041C0700X
NCC012455101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical