Provider Demographics
NPI:1740515360
Name:BRIGHT, REGINA ANN (LMHC)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:ANN
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MARY ESTHER BLVD
Mailing Address - Street 2:SUITE 310 A.
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1974
Mailing Address - Country:US
Mailing Address - Phone:850-598-4462
Mailing Address - Fax:850-254-1986
Practice Address - Street 1:151 MARY ESTHER BLVD
Practice Address - Street 2:SUITE 310 A.
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1974
Practice Address - Country:US
Practice Address - Phone:850-598-4462
Practice Address - Fax:850-254-1986
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health