1376718098 NPI number — MRS. MANDI RENEE DUGGAN LMHC, LMFT, NCC, LPC

Table of content: MRS. MANDI RENEE DUGGAN LMHC, LMFT, NCC, LPC (NPI 1376718098)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376718098 NPI number — MRS. MANDI RENEE DUGGAN LMHC, LMFT, NCC, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUGGAN
Provider First Name:
MANDI
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC, LMFT, NCC, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SJOGREN
Provider Other First Name:
MANDI
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHC, LPC, NCC, LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376718098
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 STONEBURY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARDEN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28704-6616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-702-7482
Provider Business Mailing Address Fax Number:
561-828-7720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 STONEBURY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARDEN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28704-6616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-702-7482
Provider Business Practice Location Address Fax Number:
561-828-7720
Provider Enumeration Date:
04/23/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  14621 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: MH8930 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: LH61065584 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 2508 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: MT2698 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)