REGINA MARIE ELY (NPI# 1902366198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902366198 |
| Entity Type | Individual |
| Full Name | REGINA MARIE ELY |
| Credential | LCSW |
| Practice Address |
2799 Medford Ave Ste 11 Medford NY 11763-2535 |
| Mailing Address |
29 Lacebark Ln Medford NY 11763-4126 |
| Practice Telephone | 6317325222 |
| Practice Fax Number | 6317326222 |
| Mailing Telephone | 6318075996 |
| Mailing Fax Number | 6314440102 |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2020-06-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 079964 | NY | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
089452 | NY | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1413 Stony Brook Rd, Stony Brook, NY 117902214 | 6314440101 | 6314440102 |
| Street Address |
2799 MEDFORD AVE STE 11 |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763-2535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1962053348 | Monica Lorraine Schlie | Social Worker | 18 Forrest Ave, Medford, NY 11763-2609 | 2019-09-26 |
| 1578129623 | Patricia M Sullivan | Social Worker | 29 Welgate Rd, Medford, MA 02155-2150 | 2019-05-14 |
| 1013483841 | Howard David Harris | Social Worker | 259 Park St - Apt. 2, Medford, MA 02155-2666 | 2018-10-19 |
| 1871078469 | Lorraine Lafata | Social Worker | 14 Kilsyth Rd Fl 1, Medford, MA 02155-6522 | 2018-09-28 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1184108292 | Nancy Ann Woodfork | Social Worker | 3600 Mystic Valley Pkwy Apt W315, Medford, MA 02155-5741 | 2018-09-24 |
| 1295218758 | Julia Dennon Wise | Social Worker | 17 Wyman St, Medford, MA 02155-3401 | 2018-09-11 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1932680840 | Shreya Bansal | Social Worker | 3920 Mystic Valley Pkwy Apt 602, Medford, MA 02155-6907 | 2018-08-28 |
| Find all providers in MEDFORD | ||||
Please comment or provide details below to improve the information on REGINA MARIE ELY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.