Provider Demographics
NPI:1154032779
Name:KREPPEL, REGINA (LCSW)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:KREPPEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 LAKE RD PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-0207
Mailing Address - Country:US
Mailing Address - Phone:631-365-3469
Mailing Address - Fax:
Practice Address - Street 1:65A N GRANT AVE
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-1934
Practice Address - Country:US
Practice Address - Phone:845-461-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NY0843241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical