Healthcare Provider Details

I. General information

NPI: 1497682025
Provider Name (Legal Business Name): REGAN CHAVEZ MS, CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 COLLEGE ST
CLINTON NC
28328-3502
US

IV. Provider business mailing address

620 COLLEGE ST
CLINTON NC
28328-3502
US

V. Phone/Fax

Practice location:
  • Phone: 910-299-0700
  • Fax: 910-299-0800
Mailing address:
  • Phone: 910-299-0700
  • Fax: 910-299-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30004957
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: