Provider Demographics
NPI:1285965459
Name:REGINA M. DOYLE, LCSW, LLC
Entity type:Organization
Organization Name:REGINA M. DOYLE, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-489-3786
Mailing Address - Street 1:245 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-4571
Mailing Address - Country:US
Mailing Address - Phone:908-489-3786
Mailing Address - Fax:732-263-0633
Practice Address - Street 1:245 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-4571
Practice Address - Country:US
Practice Address - Phone:908-489-3786
Practice Address - Fax:732-263-0633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC050597001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty