Provider Demographics
NPI:1124330527
Name:NAY, REGINA L (LMHC)
Entity type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:L
Last Name:NAY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:REGINA
Other - Middle Name:
Other - Last Name:MAIN-BAILLIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:695 CENTRAL AVE STE 278
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3669
Mailing Address - Country:US
Mailing Address - Phone:305-431-4242
Mailing Address - Fax:
Practice Address - Street 1:695 CENTRAL AVE STE 278
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3669
Practice Address - Country:US
Practice Address - Phone:305-431-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9655101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003043100Medicaid
FL003043100Medicaid