Individual
REGINALD T BIRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
126882-121
WI
1041C0700X
Clinical Social Worker
Primary
8520-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487999207
—
WI
Enumeration date
12/05/2012
Last updated
05/19/2022
Update your record
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