Provider Demographics
NPI:1609185545
Name:REGAN, CAROLYN ESPOSITO (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ESPOSITO
Last Name:REGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BEAVER AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1017
Mailing Address - Country:US
Mailing Address - Phone:908-454-7244
Mailing Address - Fax:908-859-2109
Practice Address - Street 1:90 BEAVER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1017
Practice Address - Country:US
Practice Address - Phone:908-454-7244
Practice Address - Fax:908-859-2109
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X
NJPERMIT103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool