Provider Demographics
NPI:1427615640
Name:MCELHENNEY, REGINA
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:MCELHENNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 CRESCENT ST APT C1
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3360
Mailing Address - Country:US
Mailing Address - Phone:347-426-6861
Mailing Address - Fax:
Practice Address - Street 1:460 W 34TH ST FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2382
Practice Address - Country:US
Practice Address - Phone:347-426-6861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool