Provider Demographics
NPI:1871886143
Name:LAWSON, REGINA (LICSW)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12402 CECILY CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5648
Mailing Address - Country:US
Mailing Address - Phone:917-577-8520
Mailing Address - Fax:
Practice Address - Street 1:12402 CECILY CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5648
Practice Address - Country:US
Practice Address - Phone:917-577-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD319041041C0700X
VA09040143261041C0700X
DCLC500788231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical