Provider Demographics
NPI:1760435465
Name:RAGAN, REGINA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:
Last Name:RAGAN
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 1:87 S ELLIOTT RD
Mailing Address - Street 2:STE. 212
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5824
Mailing Address - Country:US
Mailing Address - Phone:919-967-2520
Mailing Address - Fax:919-967-0515
Practice Address - Street 1:87 S ELLIOTT RD
Practice Address - Street 2:STE. 212
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5824
Practice Address - Country:US
Practice Address - Phone:919-967-2520
Practice Address - Fax:919-967-0515
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0040181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC132PROtherBCBS PROVIDER NUMBER
NC6106271Medicaid
NC132PROtherBCBS PROVIDER NUMBER