Provider Demographics
NPI:1962626713
Name:COGAN, DEIRDRE MARSHA (LPC, ATR)
Entity Type:Individual
Prefix:MS
First Name:DEIRDRE
Middle Name:MARSHA
Last Name:COGAN
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:MS
Other - First Name:DEIRDRE
Other - Middle Name:M
Other - Last Name:COGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, ATR
Mailing Address - Street 1:1250 U ST NW
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-7522
Mailing Address - Country:US
Mailing Address - Phone:202-671-1261
Mailing Address - Fax:
Practice Address - Street 1:1250 U ST NW
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-7522
Practice Address - Country:US
Practice Address - Phone:202-671-1261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional