Provider Demographics
NPI:1770676835
Name:NAUGLE, DAVID C (LCSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:NAUGLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 RIDGEWOOD ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-6977
Mailing Address - Country:US
Mailing Address - Phone:610-378-9601
Mailing Address - Fax:610-378-3610
Practice Address - Street 1:2201 RIDGEWOOD ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-6977
Practice Address - Country:US
Practice Address - Phone:610-378-9601
Practice Address - Fax:610-378-3610
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA645181XTGMedicare PIN
PARO8051Medicare UPIN
PA645181Medicare PIN