Eberhart, Regan R

Eberhart, Regan R is an individual health care provider with primary practice located at 1095 Midway Rd , Menasha WI 54952-1115. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Eberhart, Regan R can be contacted via phone (920) 720-2300.

Contact Information

Primary practice address
1095 Midway Rd Menasha WI 54952-1115
Phone: (920) 720-2300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X RC00056209 Washington
Behavioral Health & Social Service Providers / Social Worker 104100000X LW60167698 Washington
Behavioral Health & Social Service Providers / Social Worker 104100000X 8795 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X LW60167698 Washington
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8795 Wisconsin

Profile Details

NPI number 1508911959
LBN Legal business name Eberhart, Regan R
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2007
Last updated Nov 15th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508911959 NPPES
Washington MEDICAID 2017451

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