Provider Demographics
NPI:1639988892
Name:SPIERS, REGINA FOWLER (P-LPC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:FOWLER
Last Name:SPIERS
Suffix:
Gender:F
Credentials:P-LPC
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:FOWLER
Other - Last Name:SPIERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 CHIMNEY CROSS
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:MS
Mailing Address - Zip Code:39560-6313
Mailing Address - Country:US
Mailing Address - Phone:228-861-2966
Mailing Address - Fax:
Practice Address - Street 1:2550 MARSHALL RD STE 300
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4747
Practice Address - Country:US
Practice Address - Phone:228-207-3549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-1272101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional