Provider Demographics
NPI:1497821219
Name:JUHL, REGINA KAY (LMHP, LADC)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:KAY
Last Name:JUHL
Suffix:
Gender:F
Credentials:LMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 WEST ANNA
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801
Mailing Address - Country:US
Mailing Address - Phone:308-398-0350
Mailing Address - Fax:308-398-0352
Practice Address - Street 1:715 W ANNA ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-6713
Practice Address - Country:US
Practice Address - Phone:308-398-0350
Practice Address - Fax:308-398-0352
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health