Healthcare Provider Details

I. General information

NPI: 1235481425
Provider Name (Legal Business Name): MARLENE ANN REGAN MS. LPC, NCC, SAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 ENTERPRISE LN STE 301
MADISON WI
53719-1193
US

IV. Provider business mailing address

6300 ENTERPRISE LN STE 301
MADISON WI
53719-1193
US

V. Phone/Fax

Practice location:
  • Phone: 608-828-3636
  • Fax: 608-828-3637
Mailing address:
  • Phone: 608-828-3636
  • Fax: 608-828-3637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number491-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: