Provider Demographics
NPI:1700964277
Name:EBAUGH, DAVID HULL (MA,LCPC,CCDC,CEAP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HULL
Last Name:EBAUGH
Suffix:
Gender:M
Credentials:MA,LCPC,CCDC,CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PARK CENTER CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5601
Mailing Address - Country:US
Mailing Address - Phone:410-356-3344
Mailing Address - Fax:410-356-4459
Practice Address - Street 1:6 PARK CENTER CT
Practice Address - Street 2:SUITE 103
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5601
Practice Address - Country:US
Practice Address - Phone:410-356-3344
Practice Address - Fax:410-356-4459
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0686101YA0400X
MDLC OO84101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health