Provider Demographics
NPI:1982096574
Name:ELIGAN, JOHARI (LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:JOHARI
Middle Name:
Last Name:ELIGAN
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 MERGANSER CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7015
Mailing Address - Country:US
Mailing Address - Phone:413-883-0322
Mailing Address - Fax:
Practice Address - Street 1:1305 MERGANSER CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7015
Practice Address - Country:US
Practice Address - Phone:413-883-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14505101YP2500X
MDLC11013101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional