Provider Demographics
NPI:1497780191
Name:HANNANT, REGAN LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REGAN
Middle Name:LEE
Last Name:HANNANT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 TRUE VINE RD. NE
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-8800
Mailing Address - Country:US
Mailing Address - Phone:919-252-4816
Mailing Address - Fax:919-734-9050
Practice Address - Street 1:2401 WOOTEN BLVD SW STE K
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4464
Practice Address - Country:US
Practice Address - Phone:252-291-0735
Practice Address - Fax:252-291-2890
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0050031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003749Medicaid