Individual provider Active NPI

Carolyn Esposito Regan, PHD

  • Clinical Psychologist
  • Clinton, NJ
National Provider Identifier
1609185545
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PERMIT Issued in NJ
Practice address
90 Beaver Ave
Clinton, NJ 08809-1017
Phone
(908) 454-7244
Fax
(908) 859-2109
NPI assigned
Sep 27, 2010
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X
Clinical Psychologist 103TC0700X PERMIT NJ Primary

Addresses

Primary practice location

90 Beaver Ave
Clinton, NJ 08809-1017

Mailing address

90 Beaver Ave
Clinton, NJ 08809-1017
Phone (908) 454-7244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803000628 NJ Practitioner - Clinical Psychologist 6406271816 Reassigns benefits to 1 organization
Practice locations: Clinton, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

90 Beaver Ave
Clinton, NJ 08809-1017
Phone (484) 892-5856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PERMITNJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Jul 1, 2020 Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Jul 1, 2020 Accepting new patients
Carolyn Regan Counseling & Psychotherapy Clinical CurrentSince Jul 13, 2022 Accepting new patients

Locations

90 Beaver Ave
Clinton, NJ 08809
Phone (484) 892-5856

305 Roseberry St
Ste 8
Phillipsburg, NJ 08865
Phone (908) 454-7244

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1609185545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BEAVER AVE",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088091017",
            "telephone_number": "908-454-7244",
            "fax_number": "908-859-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BEAVER AVE",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088091017",
            "telephone_number": "908-454-7244",
            "fax_number": "908-859-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "CAROLYN",
        "middle_name": "ESPOSITO",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "PERMIT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NJ

Sources for this page

Verify at the official NPI Registry.