Provider Demographics
NPI:1326711581
Name:HALES, REGINA JONES (LCMHCA)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:JONES
Last Name:HALES
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E HORTON ST
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-2823
Mailing Address - Country:US
Mailing Address - Phone:919-333-4338
Mailing Address - Fax:
Practice Address - Street 1:3134 WENDELL BLVD
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-7271
Practice Address - Country:US
Practice Address - Phone:919-374-7283
Practice Address - Fax:919-374-7285
Is Sole Proprietor?:No
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16534101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health