Provider Demographics
NPI:1477376085
Name:JOANNE BAGSHAW & ASSOCIATES
Entity type:Organization
Organization Name:JOANNE BAGSHAW & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCPC
Authorized Official - Phone:301-288-3723
Mailing Address - Street 1:745 CHESTERTOWN ST
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5755
Mailing Address - Country:US
Mailing Address - Phone:631-697-5568
Mailing Address - Fax:
Practice Address - Street 1:316 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6551
Practice Address - Country:US
Practice Address - Phone:301-288-3723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health