Provider Demographics
NPI:1922761550
Name:REGAN, MELISSA B (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:B
Last Name:REGAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 EDGECLIFFE DR APT 5
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-1552
Mailing Address - Country:US
Mailing Address - Phone:818-292-0224
Mailing Address - Fax:
Practice Address - Street 1:2034 COTNER AVE STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5664
Practice Address - Country:US
Practice Address - Phone:818-335-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist