Provider Demographics
NPI:1053653063
Name:HAGER, REGAN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:REGAN
Middle Name:
Last Name:HAGER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 BAYOU BLVD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1949
Mailing Address - Country:US
Mailing Address - Phone:850-462-3595
Mailing Address - Fax:850-607-2771
Practice Address - Street 1:4300 BAYOU BLVD
Practice Address - Street 2:SUITE 21
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-1949
Practice Address - Country:US
Practice Address - Phone:850-462-3595
Practice Address - Fax:850-607-2771
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health