Provider Demographics
NPI:1770921504
Name:AGUGLIA, REGIS ALLEN III (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:REGIS
Middle Name:ALLEN
Last Name:AGUGLIA
Suffix:III
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 GLASTONBURY WAY
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3333
Mailing Address - Country:US
Mailing Address - Phone:412-585-6346
Mailing Address - Fax:
Practice Address - Street 1:620 S MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3943
Practice Address - Country:US
Practice Address - Phone:410-709-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16003104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker