Provider Demographics
NPI:1558356931
Name:PUGH, MARIAN (LCSWC)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:PUGH
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SCHILLING RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1191
Mailing Address - Country:US
Mailing Address - Phone:410-527-0280
Mailing Address - Fax:410-771-9208
Practice Address - Street 1:9 SCHILLING RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-1191
Practice Address - Country:US
Practice Address - Phone:410-527-0280
Practice Address - Fax:410-771-9208
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7557101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
7140244 PPOOtherAUSHC
927622OtherFIRST HEALTH NETWORK PPO
057367OtherVALUE OPTIONS
126581OtherAPS
DC28670005OtherCAREFIRST
MD54327701OtherCAREFIRST
263981OtherMAMSI
2702256 HMOOtherAUSHC
263981OtherALLIANCE
299692OtherMHN
057367OtherVALUE OPTIONS
MD54327701OtherCAREFIRST