Provider Demographics
NPI:1700149481
Name:HOGAN-RIGG, DANIEL W (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:W
Last Name:HOGAN-RIGG
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:W
Other - Last Name:HOGAN
Other - Suffix:V
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:780 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2755
Mailing Address - Country:US
Mailing Address - Phone:857-654-1000
Mailing Address - Fax:857-654-1100
Practice Address - Street 1:780 ALBANY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2755
Practice Address - Country:US
Practice Address - Phone:857-654-1000
Practice Address - Fax:857-654-1100
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1188081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110110362AMedicaid