Provider Demographics
NPI:1225194301
Name:COLANGELO, REGINA A (LCSW)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:A
Last Name:COLANGELO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-0226
Mailing Address - Country:US
Mailing Address - Phone:914-934-8861
Mailing Address - Fax:914-939-0145
Practice Address - Street 1:16 SCHOOL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2952
Practice Address - Country:US
Practice Address - Phone:914-934-8861
Practice Address - Fax:914-939-0145
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR019095-11041C0700X
CT0032521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN14491Medicare ID - Type Unspecified