Provider Demographics
NPI:1598850471
Name:DOYLE, REGINA (LCSW)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:DOYLE
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 1:245 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-4571
Mailing Address - Country:US
Mailing Address - Phone:908-489-3786
Mailing Address - Fax:732-263-0633
Practice Address - Street 1:245 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-4571
Practice Address - Country:US
Practice Address - Phone:908-489-3786
Practice Address - Fax:732-263-0633
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050597001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical