Provider Demographics
NPI:1730553975
Name:REGAL OAK COUNSELING, LLC
Entity type:Organization
Organization Name:REGAL OAK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S
Authorized Official - Phone:682-651-7621
Mailing Address - Street 1:PO BOX 163781
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76161-3781
Mailing Address - Country:US
Mailing Address - Phone:682-651-7621
Mailing Address - Fax:
Practice Address - Street 1:1285 N MAIN ST
Practice Address - Street 2:SUITE 101-5
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-1510
Practice Address - Country:US
Practice Address - Phone:682-651-7621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-27
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty