Individual
MR. ALAN GREGORY BAGSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LCAS
Contact information
Practice address
200 N MAIN ST, MOUNT AIRY, NC 27030-3810
(336) 909-0192
Mailing address
1022 N MAIN ST, MOUNT AIRY, NC 27030-3636
(336) 909-0192
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-24956
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
CO15083
NC
1041C0700X
Clinical Social Worker
P014395
NC
Other
Enumeration date
02/17/2012
Last updated
09/25/2023
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