Provider Demographics
NPI:1275977183
Name:DUGDALE, BRIAN (LPCA)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:DUGDALE
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4302
Mailing Address - Country:US
Mailing Address - Phone:864-923-5658
Mailing Address - Fax:
Practice Address - Street 1:244 5TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4302
Practice Address - Country:US
Practice Address - Phone:864-923-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10005101YP2500X
NCA10005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional