Provider Demographics
NPI:1265548218
Name:DUGAN, JANICE STEWART (PHD, LPC, LCADC)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:STEWART
Last Name:DUGAN
Suffix:
Gender:F
Credentials:PHD, LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E MANTUA AVE
Mailing Address - Street 2:
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-1950
Mailing Address - Country:US
Mailing Address - Phone:856-854-3155
Mailing Address - Fax:856-854-0992
Practice Address - Street 1:215 HIGHLAND AVE
Practice Address - Street 2:SUITE C28-29
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-2634
Practice Address - Country:US
Practice Address - Phone:856-854-3155
Practice Address - Fax:856-854-0992
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00094100101YA0400X, 101YM0800X
NJ37PC00309200101YP2500X
NJPC002201103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health