Provider Demographics
NPI:1770393274
Name:MONGOLD, SYLVIA REGAN (ATR-BC)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:REGAN
Last Name:MONGOLD
Suffix:
Gender:F
Credentials:ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2286
Mailing Address - Country:US
Mailing Address - Phone:703-596-9557
Mailing Address - Fax:
Practice Address - Street 1:1008 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2286
Practice Address - Country:US
Practice Address - Phone:703-596-9557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional