Healthcare Provider Details

I. General information

NPI: 1043714652
Provider Name (Legal Business Name): REGAN MARGARET SPRINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 INDEPENDENCE BLVD STE 100-035
WILMINGTON NC
28412-2571
US

IV. Provider business mailing address

1402 KELLUM CT
WILMINGTON NC
28412-5114
US

V. Phone/Fax

Practice location:
  • Phone: 910-338-3804
  • Fax:
Mailing address:
  • Phone: 704-560-8493
  • Fax: 910-213-3998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC012455
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPO11580
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: