MEDICARE: MRS. AMBER R REGAL LMHC, CAP, CCTP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH18847	FL

General Provider Information

NPI Number	:	1629521125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMBER R REGAL LMHC, CAP, CCTP

Provider Business Mailing Address
First Line	:	6009 GIBSON AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-1327
Country	:	US
Telephone Number	:	813-863-1585
Fax Number	:

Provider Business Practice Location Address
First Line	:	6009 GIBSON AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-1327
Country	:	US
Telephone Number	:	813-863-1585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2016
Last Update Date	:	04/06/2026

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