Provider Demographics
NPI:1184493199
Name:REGAN, ERIN ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:REGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21838 N 40TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-7224
Mailing Address - Country:US
Mailing Address - Phone:928-502-2489
Mailing Address - Fax:
Practice Address - Street 1:15455 N GREENWAY HAYDEN LOOP STE C9
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1887
Practice Address - Country:US
Practice Address - Phone:480-418-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-15364104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker