Provider Demographics
NPI:1689192064
Name:AGUILAR KUGAJEVSKY, N. CAROLINE (LPC)
Entity Type:Individual
Prefix:
First Name:N. CAROLINE
Middle Name:
Last Name:AGUILAR KUGAJEVSKY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 BRADENTON AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-7586
Mailing Address - Country:US
Mailing Address - Phone:614-263-8161
Mailing Address - Fax:
Practice Address - Street 1:270 BRADENTON AVE STE 110
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-7586
Practice Address - Country:US
Practice Address - Phone:614-263-8161
Practice Address - Fax:614-263-8161
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1700338101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health