Provider Demographics
NPI:1417717091
Name:MCGIBONEY, REGINA R (LPC, LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:R
Last Name:MCGIBONEY
Suffix:
Gender:F
Credentials:LPC, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5906 CARMICHAEL PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2345
Mailing Address - Country:US
Mailing Address - Phone:334-277-1334
Mailing Address - Fax:
Practice Address - Street 1:5906 CARMICHAEL PL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2345
Practice Address - Country:US
Practice Address - Phone:334-277-1334
Practice Address - Fax:334-277-1445
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSC03273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty