Provider Demographics
NPI:1265507255
Name:LEGGETT, REGINA ELIZABETH (MA LPA)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:ELIZABETH
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:MA LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219-D COMMERCE STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5031
Mailing Address - Country:US
Mailing Address - Phone:252-321-7677
Mailing Address - Fax:
Practice Address - Street 1:219-D COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5031
Practice Address - Country:US
Practice Address - Phone:252-321-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2410101YP2500X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE2336OtherMEDCOST