Provider Demographics
NPI:1740436823
Name:LIEN, REGINA M (MS, LPC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:M
Last Name:LIEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 157TH ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-9004
Mailing Address - Country:US
Mailing Address - Phone:715-723-4130
Mailing Address - Fax:
Practice Address - Street 1:345 FRENETTE DR STE 4
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3072
Practice Address - Country:US
Practice Address - Phone:715-861-7762
Practice Address - Fax:715-861-7762
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4017-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health