Provider Demographics
NPI:1003400201
Name:DUGGAN, PATRICIA SUNSHINE (LCMCHA, LCASA,NCC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUNSHINE
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:LCMCHA, LCASA,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5718 WATERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1073
Mailing Address - Country:US
Mailing Address - Phone:941-914-2172
Mailing Address - Fax:
Practice Address - Street 1:5135 MORGANTON RD STE 104
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1525
Practice Address - Country:US
Practice Address - Phone:910-216-9256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-27
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26781101YA0400X
NCA16360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1003400201OtherNPI