Provider Demographics
NPI:1851314397
Name:REGAN, TERESA ANN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ANN
Last Name:REGAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11814 NE 80TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8119
Mailing Address - Country:US
Mailing Address - Phone:206-290-9097
Mailing Address - Fax:
Practice Address - Street 1:401 PARKPLACE CTR
Practice Address - Street 2:SUITE 319
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6295
Practice Address - Country:US
Practice Address - Phone:206-290-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health