Healthcare Provider Details

I. General information

NPI: 1619886371
Provider Name (Legal Business Name): REGAN KERR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 OLD ROAD TO 9 ACRE COR
CONCORD MA
01742-4169
US

IV. Provider business mailing address

104 NONANTUM ST
BRIGHTON MA
02135-2410
US

V. Phone/Fax

Practice location:
  • Phone: 302-723-9230
  • Fax:
Mailing address:
  • Phone: 302-723-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number230978
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: