Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Regina Marie Ely, LCSW

Individual provider Social Worker · NPI 1902366198

Regina Marie Ely, LCSW is a Social Worker in Medford, New York. Practices as a sole proprietor and works from 3 locations. Licensed in New York.

Licensed in
NY
In the registry since
2019
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2799 Medford Ave Ste 11
Medford, NY 11763-2535
Phone: (631) 732-5222
Fax: (631) 732-6222
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 29 Lacebark Ln, Medford, NY 11763-4126 — (631) 807-5996
  • 1413 Stony Brook Rd, Stony Brook, NY 11790-2214 — (631) 444-0101

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 089452 (NY)
Social Worker Taxonomy 104100000X · Licence 079964 (NY)

Record details

NPI number1902366198
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 22, 2019
Last updated in NPPESMarch 18, 2024
Certification dateMarch 18, 2024

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