Provider Demographics
NPI:1982731121
Name:REGNER, STEPHEN C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:C
Last Name:REGNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8196 SW HALL BLVD STE 335
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-4036
Mailing Address - Country:US
Mailing Address - Phone:503-641-9353
Mailing Address - Fax:
Practice Address - Street 1:8196 SW HALL BLVD STE 335
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-4036
Practice Address - Country:US
Practice Address - Phone:503-641-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical