Provider Demographics
NPI:1114235132
Name:UGOJI, CHUCK C (MA)
Entity Type:Individual
Prefix:
First Name:CHUCK
Middle Name:C
Last Name:UGOJI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 MERCANTILE LANE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774
Mailing Address - Country:US
Mailing Address - Phone:301-386-7722
Mailing Address - Fax:301-386-7789
Practice Address - Street 1:1400 MERCANTILE LANE
Practice Address - Street 2:SUITE 206
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:301-386-7722
Practice Address - Fax:301-386-7789
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health