Regina Marie Walsh, LPC – Professional Counselor

Key facts

NPI: 1710243738
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: 001706 (CT)
Practice address: 15 North Main Street
Chester, CT 06412-0641
Phone: (860) 510-1211
Fax: (860) 510-1211
NPI assigned: Apr 3, 2012
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
001706	CT	MD	Physician Assistant

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	001706	CT	Yes

Addresses

Primary practice location

15 North Main Street
Chester, CT 06412-0641

Mailing address

79 Oak Rd
East Haddam, CT 06423-1109
Phone (860) 510-1211

Other practice location 1

91 Northwest Dr
Plainville, CT 06062-1534
Phone (860) 886-3733

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710243738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 OAK RD",
            "city": "EAST HADDAM",
            "state": "CT",
            "postal_code": "064231109",
            "telephone_number": "860-510-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 NORTH MAIN STREET",
            "city": "CHESTER",
            "state": "CT",
            "postal_code": "064120641",
            "telephone_number": "860-510-1211",
            "fax_number": "860-510-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Northwest Dr",
            "address_purpose": "LOCATION",
            "city": "Plainville",
            "state": "CT",
            "postal_code": "060621534",
            "country_code": "US",
            "telephone_number": "860-886-3733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "REGINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, CT

All providers in Chester, CT · Professional Counselor in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.