Provider Demographics
NPI:1265684179
Name:NADIR, REGINA MILLER (LCSW-C, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MILLER
Last Name:NADIR
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1411
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20717-1411
Mailing Address - Country:US
Mailing Address - Phone:301-758-7058
Mailing Address - Fax:301-218-7358
Practice Address - Street 1:8201 CORPORATE DR STE 500
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2235
Practice Address - Country:US
Practice Address - Phone:301-758-7058
Practice Address - Fax:301-218-7358
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD136671041C0700X
DCLC500784611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical