Provider Demographics
NPI:1609610617
Name:REGANATO, ANDREA (LMFT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:REGANATO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BUSINESS CENTER DR STE 205
Mailing Address - Street 2:
Mailing Address - City:EASTANOLLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30538-3254
Mailing Address - Country:US
Mailing Address - Phone:706-599-6198
Mailing Address - Fax:
Practice Address - Street 1:11 BUSINESS CENTER DR STE 205
Practice Address - Street 2:
Practice Address - City:EASTANOLLEE
Practice Address - State:GA
Practice Address - Zip Code:30538-3254
Practice Address - Country:US
Practice Address - Phone:706-599-6198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT002077106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist