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General NPI Number Information
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NPI Number | 1104278266
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Entity Type | Individual
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Provider Name | RAEGAN THOMAS MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 5335 W 48TH AVE
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City | DENVER
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State | CO
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Zip | 80212-2700
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Country | US
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Telephone | 720-255-1507
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Fax |
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Provider Business Mailing Address
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Address Line | 6337 W 6TH AVE
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City | LAKEWOOD
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State | CO
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Zip | 80214-2362
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Country | US
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Telephone | 303-912-7772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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