Provider Demographics
NPI:1184412157
Name:DEOUD, REGINA (LGPC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:DEOUD
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ROSS ST # 154-0455
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15262-0001
Mailing Address - Country:US
Mailing Address - Phone:703-841-1290
Mailing Address - Fax:
Practice Address - Street 1:10400 LITTLE PATUXENT PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3518
Practice Address - Country:US
Practice Address - Phone:571-977-6870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12391101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor