Provider Demographics
NPI:1134656879
Name:REGAN, HEATHER O'QUINN (LPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:O'QUINN
Last Name:REGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:O'QUINN
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:5400 RAMSEY ST
Mailing Address - Street 2:PEARCE HALL
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1420
Mailing Address - Country:US
Mailing Address - Phone:910-630-7150
Mailing Address - Fax:910-630-7263
Practice Address - Street 1:5400 RAMSEY ST
Practice Address - Street 2:PEARCE HALL
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1420
Practice Address - Country:US
Practice Address - Phone:910-630-7150
Practice Address - Fax:910-630-7263
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health