Provider Demographics
NPI:1164441614
Name:RAGAN, CLAUDE P (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:P
Last Name:RAGAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 W MARKET ST STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1378
Mailing Address - Country:US
Mailing Address - Phone:336-855-6314
Mailing Address - Fax:336-855-6325
Practice Address - Street 1:3719 W MARKET ST STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1378
Practice Address - Country:US
Practice Address - Phone:336-855-6314
Practice Address - Fax:336-855-6325
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC593103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC04466OtherBLUECROSS BLUESHIELD
NC2811637Medicare ID - Type UnspecifiedMEDICARE