1134148893 NPI number — JOHN P DUGGAN MA, NCC, LCPC, LPC

Table of content: JOHN P DUGGAN MA, NCC, LCPC, LPC (NPI 1134148893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134148893 NPI number — JOHN P DUGGAN MA, NCC, LCPC, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUGGAN
Provider First Name:
JOHN
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, NCC, LCPC, LPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134148893
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8720 GEORGIA AVE
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20910-3638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-374-1000
Provider Business Mailing Address Fax Number:
877-825-4735

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8720 GEORGIA AVE
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20910-3638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-374-1000
Provider Business Practice Location Address Fax Number:
877-825-4735
Provider Enumeration Date:
07/19/2006

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: 101YP2500X , with the licence number:  LC2214 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: PRC13893 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 643218 . This is a "MARYLAND MEDICARE PROVIDER ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com