Provider Demographics
NPI:1740923382
Name:CAROLYN REGAN COUNSELING & PSYCHOTHERAPY
Entity type:Organization
Organization Name:CAROLYN REGAN COUNSELING & PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:REGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-892-5856
Mailing Address - Street 1:5975 ROUTE 412
Mailing Address - Street 2:
Mailing Address - City:RIEGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18077-9739
Mailing Address - Country:US
Mailing Address - Phone:484-892-5856
Mailing Address - Fax:
Practice Address - Street 1:90 BEAVER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1017
Practice Address - Country:US
Practice Address - Phone:484-892-5856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty