Individual
MR. JAMES WILLIAM REAGAN LCSWC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSWC CLINICAL SOCIA
Contact information
Practice address
19758 DOGSTREET RD, KEEDYSVILLE, MD 21756
(301) 432-0594
Mailing address
19758 DOGSTREET RD, KEEDYSVILLE, MD 21756
(301) 432-0594
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00703
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34829001
BLUE CROSS CARE FIRST
MD
Enumeration date
02/08/2007
Last updated
07/08/2007
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