Provider Demographics
NPI:1376090308
Name:DEGNAN, CAROLINE
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:DEGNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 E MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-2781
Mailing Address - Country:US
Mailing Address - Phone:412-805-7214
Mailing Address - Fax:412-246-3882
Practice Address - Street 1:331 E MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-2781
Practice Address - Country:US
Practice Address - Phone:412-805-7214
Practice Address - Fax:412-246-3882
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health