Provider Demographics
NPI:1992362032
Name:HANCOCK, REGINA LYNN (LPCC-S)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:LYNN
Last Name:HANCOCK
Suffix:
Gender:
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-9209
Mailing Address - Country:US
Mailing Address - Phone:270-735-2626
Mailing Address - Fax:
Practice Address - Street 1:408 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9209
Practice Address - Country:US
Practice Address - Phone:270-735-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY252082101Y00000X, 101YM0800X
KY164560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100800970Medicaid