Provider Demographics
NPI:1356519466
Name:MINGOLA, REGINA CELESTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:REGINA
Middle Name:CELESTE
Last Name:MINGOLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:REGINA
Other - Middle Name:CELESTE
Other - Last Name:VIEIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1265 E RODNEY FRENCH BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02744-2030
Mailing Address - Country:US
Mailing Address - Phone:508-994-7204
Mailing Address - Fax:
Practice Address - Street 1:389 COUNTY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-4995
Practice Address - Country:US
Practice Address - Phone:508-997-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214857174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist