Active NPI
Tara Reagan, PSY.D., L.M.H.C.A.
- Mental Health Counselor
- Waterville, ME
National Provider Identifier
1255753166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC60427973
- Practice address
- 149 North St
Waterville, ME 04901-4974 - Phone
- (207) 872-4303
- NPI assigned
- Jan 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60427973 | WA | Primary |
Addresses
Primary practice location
149 North St
Waterville, ME 04901-4974
Mailing address
149 North St
Waterville, ME 04901-4974
Phone (207) 872-4303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC60427973 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449187200000",
"number": "1255753166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 NORTH ST",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049014974",
"telephone_number": "207-872-4303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 NORTH ST",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049014974",
"telephone_number": "207-872-4303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAGAN",
"first_name": "TARA",
"credential": "PSY.D., L.M.H.C.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-11",
"last_updated": "2015-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60427973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterville, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.