Blackwolf, Regina A

Blackwolf, Regina A is an individual health care provider with primary practice located at 12812 3Rd Ave Se Ste A , Everett WA 98208-6455. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Blackwolf, Regina A can be contacted via phone (206) 375-7657.

Contact Information

Primary practice address
12812 3Rd Ave Se Ste A Everett WA 98208-6455
Phone: (206) 375-7657
Fax: (206) 319-5325
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CP00005962 Washington
Behavioral Health & Social Service Providers / Clinical 1041C0700X LW60083962 Washington

Profile Details

NPI number 1184777252
LBN Legal business name Blackwolf, Regina A
Credentials MSW, LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2007
Last updated Mar 3rd, 2023 - about 3 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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