Provider Demographics
NPI:1790807279
Name:REAGAN, STEPHEN T (MFT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:T
Last Name:REAGAN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 TAMARISK DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-9503
Mailing Address - Country:US
Mailing Address - Phone:775-857-4322
Mailing Address - Fax:
Practice Address - Street 1:2885 TAMARISK DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-9503
Practice Address - Country:US
Practice Address - Phone:775-857-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0444106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist