Provider Demographics
NPI:1790273043
Name:VOGAN, ERIC (LPC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:VOGAN
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 1:7520 PENN AVE APT 22
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2543
Mailing Address - Country:US
Mailing Address - Phone:724-614-2259
Mailing Address - Fax:
Practice Address - Street 1:134 S HIGHLAND AVE STE 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3968
Practice Address - Country:US
Practice Address - Phone:724-614-2259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional