Provider Demographics
NPI:1952454985
Name:REGAN, CARA LESLIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:LESLIE
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 1:101 SULLYS TRL
Mailing Address - Street 2:MEADOWGATE OFFICE PARK SUITE 10
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4552
Mailing Address - Country:US
Mailing Address - Phone:585-586-8550
Mailing Address - Fax:
Practice Address - Street 1:101 SULLYS TRL
Practice Address - Street 2:MEADOWGATE OFFICE PARK SUITE 10
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4552
Practice Address - Country:US
Practice Address - Phone:585-586-8550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013083103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical