Provider Demographics
NPI:1629227517
Name:TAGGART, DONALD MATHEW (MS, CAADC, LCDP)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:MATHEW
Last Name:TAGGART
Suffix:
Gender:M
Credentials:MS, CAADC, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W 14TH ST STE 1E40
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1013
Mailing Address - Country:US
Mailing Address - Phone:302-320-6356
Mailing Address - Fax:302-320-2121
Practice Address - Street 1:254 E. MAIN ST.
Practice Address - Street 2:OPEN DOOR, INC.
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711
Practice Address - Country:US
Practice Address - Phone:302-731-1504
Practice Address - Fax:302-731-2720
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECD-0000025101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)