Provider Demographics
NPI:1710018106
Name:REGAN, FEDELE FIORE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:FEDELE
Middle Name:FIORE
Last Name:REGAN
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 1:47041 BERWICK CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:20165-7527
Mailing Address - Country:US
Mailing Address - Phone:703-421-9508
Mailing Address - Fax:
Practice Address - Street 1:47041 BERWICK CT
Practice Address - Street 2:
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-7527
Practice Address - Country:US
Practice Address - Phone:703-434-0387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical