Healthcare Provider Details

I. General information

NPI: 1356262190
Provider Name (Legal Business Name): BRIELLE JADEN REGIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MORGAN BLVD
VALPARAISO IN
46383-4836
US

IV. Provider business mailing address

288 DEEPWOOD DR
CHESTERTON IN
46304-9595
US

V. Phone/Fax

Practice location:
  • Phone: 219-617-1927
  • Fax:
Mailing address:
  • Phone: 219-617-1927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: