Provider Demographics
NPI:1134148893
Name:DUGGAN, JOHN P (MA, NCC, LCPC, LPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:DUGGAN
Suffix:
Gender:M
Credentials:MA, NCC, LCPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 GEORGIA AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3638
Mailing Address - Country:US
Mailing Address - Phone:202-374-1000
Mailing Address - Fax:877-825-4735
Practice Address - Street 1:8720 GEORGIA AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3638
Practice Address - Country:US
Practice Address - Phone:202-374-1000
Practice Address - Fax:877-825-4735
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2214101YP2500X
DCPRC13893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD643218OtherMARYLAND MEDICARE PROVIDER ID