Healthcare Provider Details

I. General information

NPI: 1801272018
Provider Name (Legal Business Name): KIERA LYNN REGAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 NEW MEADOW RD
BARRINGTON RI
02806-3733
US

IV. Provider business mailing address

372 NEW MEADOW RD
BARRINGTON RI
02806-3733
US

V. Phone/Fax

Practice location:
  • Phone: 401-338-9450
  • Fax:
Mailing address:
  • Phone: 401-338-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00407
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number65727
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number472836
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberSL007415
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: