Provider Demographics
NPI:1578222949
Name:MCKENNA, REGINA JOYCE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:REGINA
Middle Name:JOYCE
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:271 MASSACHUSETTS AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8315
Mailing Address - Country:US
Mailing Address - Phone:617-331-7979
Mailing Address - Fax:
Practice Address - Street 1:645 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-2528
Practice Address - Country:US
Practice Address - Phone:508-475-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical