Provider Demographics
NPI:1558813766
Name:DOGGETT, MURRAY (LPC)
Entity Type:Individual
Prefix:
First Name:MURRAY
Middle Name:
Last Name:DOGGETT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 E CENTER ST STE A
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-4773
Mailing Address - Country:US
Mailing Address - Phone:208-233-2025
Mailing Address - Fax:208-233-2178
Practice Address - Street 1:1352 E CENTER ST STE A
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-4773
Practice Address - Country:US
Practice Address - Phone:208-233-2025
Practice Address - Fax:208-233-2178
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC3172101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health