Provider Demographics
NPI:1558523043
Name:REGAL, CHERYL DOREEN (LCMHC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:DOREEN
Last Name:REGAL
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1812
Mailing Address - Country:US
Mailing Address - Phone:603-505-0712
Mailing Address - Fax:
Practice Address - Street 1:74 LOWELL RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1812
Practice Address - Country:US
Practice Address - Phone:603-505-0712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078246Medicaid