Provider Demographics
NPI:1093812893
Name:DUGGAN, THOMAS P (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:P
Last Name:DUGGAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 E LEE ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186
Mailing Address - Country:US
Mailing Address - Phone:540-347-0613
Mailing Address - Fax:540-347-0768
Practice Address - Street 1:54 E LEE ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-347-0613
Practice Address - Fax:540-347-0768
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040006271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008901139Medicaid
072260006OtherCAREFIRST
072260006OtherCAREFIRST