Provider Demographics
NPI:1164959896
Name:DUGGER, NADINE (MSSA,LSW)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:DUGGER
Suffix:
Gender:F
Credentials:MSSA,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1276 W 3RD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1512
Mailing Address - Country:US
Mailing Address - Phone:216-443-5633
Mailing Address - Fax:
Practice Address - Street 1:1276 W 3RD ST STE 210
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1512
Practice Address - Country:US
Practice Address - Phone:216-443-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS229911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical