Provider Demographics
NPI:1902394273
Name:MANDI DUGGAN LLC
Entity Type:Organization
Organization Name:MANDI DUGGAN LLC
Other - Org Name:SEAGRAPE COUNSELING AND CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LMFT, CCMHC,
Authorized Official - Phone:561-702-7482
Mailing Address - Street 1:825 VALLEY FORGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-3935
Mailing Address - Country:US
Mailing Address - Phone:561-702-7482
Mailing Address - Fax:561-828-7720
Practice Address - Street 1:2000 N FLORIDA MANGO RD STE 107B
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-702-7482
Practice Address - Fax:561-828-7720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8930261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health