Provider Demographics
NPI:1720772734
Name:REGAL GARDEN COUNSELING
Entity type:Organization
Organization Name:REGAL GARDEN COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIANE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-359-4235
Mailing Address - Street 1:1628 E SOUTHERN AVE STE 9626
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5782
Mailing Address - Country:US
Mailing Address - Phone:480-359-4235
Mailing Address - Fax:
Practice Address - Street 1:1628 E SOUTHERN AVE STE 9626
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5782
Practice Address - Country:US
Practice Address - Phone:480-359-4235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health