Provider Demographics
NPI:1033550215
Name:BOGLE, ARYAN KATHRYN (LCSW)
Entity type:Individual
Prefix:
First Name:ARYAN
Middle Name:KATHRYN
Last Name:BOGLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 OLEANDER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-4599
Mailing Address - Country:US
Mailing Address - Phone:919-243-1505
Mailing Address - Fax:919-585-6311
Practice Address - Street 1:34 OLEANDER DR STE 104
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-4599
Practice Address - Country:US
Practice Address - Phone:919-243-1505
Practice Address - Fax:919-585-6311
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1300058-TRNE104100000X
NCC0162921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker