James William Reagan Lcswc, LCSWC CLINICAL SOCIA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00703 Issued in MD

Practice address

19758 Dogstreet Rd
Keedysville, MD 21756

Phone

(301) 432-0594

NPI assigned

Feb 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356481022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19758 DOGSTREET RD",
            "city": "KEEDYSVILLE",
            "state": "MD",
            "postal_code": "21756",
            "telephone_number": "301-432-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19758 DOGSTREET RD",
            "city": "KEEDYSVILLE",
            "state": "MD",
            "postal_code": "21756",
            "telephone_number": "301-432-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN LCSWC",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LCSWC CLINICAL SOCIA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "00703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CARE FIRST",
            "identifier": "34829001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Keedysville, MD
• Providers in Keedysville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.