Provider Demographics
NPI:1992432793
Name:PLEASANTS, REGINA MICHELLE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:MICHELLE
Last Name:PLEASANTS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3972 LULLWATER MAIN NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-5709
Mailing Address - Country:US
Mailing Address - Phone:404-966-6642
Mailing Address - Fax:
Practice Address - Street 1:3972 LULLWATER MAIN NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-5709
Practice Address - Country:US
Practice Address - Phone:404-966-6642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW006356104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker