Provider Demographics
NPI:1790010288
Name:DEGLING, ANDREW (LPC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:DEGLING
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 1:147 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06023-1136
Mailing Address - Country:US
Mailing Address - Phone:860-944-1171
Mailing Address - Fax:860-829-1550
Practice Address - Street 1:147 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06023-1136
Practice Address - Country:US
Practice Address - Phone:860-944-1171
Practice Address - Fax:860-829-1550
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001763101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health