Provider Demographics
NPI:1669243127
Name:REGENERATIONS COUNSELING LLC
Entity type:Organization
Organization Name:REGENERATIONS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-517-1150
Mailing Address - Street 1:6540 PRISCILLA ST
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094-2738
Mailing Address - Country:US
Mailing Address - Phone:205-517-1150
Mailing Address - Fax:
Practice Address - Street 1:1900 CRESTWOOD BLVD STE B
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-2051
Practice Address - Country:US
Practice Address - Phone:205-517-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health