Provider Demographics
NPI:1992847339
Name:ELIAS, REGINA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:
Last Name:ELIAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:RONNIE
Other - Middle Name:
Other - Last Name:ELIAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:20281 E. COUNTRY CLUB DR.
Mailing Address - Street 2:APT. 1906
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3032
Mailing Address - Country:US
Mailing Address - Phone:305-978-1251
Mailing Address - Fax:305-937-0178
Practice Address - Street 1:333 W 41ST ST
Practice Address - Street 2:SUITE 702
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3641
Practice Address - Country:US
Practice Address - Phone:305-978-1252
Practice Address - Fax:305-937-0178
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW32001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical