Provider Demographics
NPI:1053189548
Name:REGNERY, ROSLYNN (LPC)
Entity type:Individual
Prefix:
First Name:ROSLYNN
Middle Name:
Last Name:REGNERY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 2ND AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-3813
Mailing Address - Country:US
Mailing Address - Phone:678-772-1446
Mailing Address - Fax:
Practice Address - Street 1:195 2ND AVE
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540-3800
Practice Address - Country:US
Practice Address - Phone:720-507-5251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0017432103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily