Provider Demographics
NPI:1598821712
Name:BUGG, TINA R (LSCSW)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:R
Last Name:BUGG
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:R
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 SW 29TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2015
Mailing Address - Country:US
Mailing Address - Phone:785-271-6551
Mailing Address - Fax:785-271-6553
Practice Address - Street 1:3601 SW 29TH ST STE 108
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2015
Practice Address - Country:US
Practice Address - Phone:785-271-6551
Practice Address - Fax:785-271-6553
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical