Provider Demographics
NPI:1366168254
Name:REGAL THERAPY LLC
Entity type:Organization
Organization Name:REGAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:REGAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:401-373-5528
Mailing Address - Street 1:74 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1812
Mailing Address - Country:US
Mailing Address - Phone:401-373-5528
Mailing Address - Fax:
Practice Address - Street 1:74 LOWELL RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1812
Practice Address - Country:US
Practice Address - Phone:401-373-5528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health