Provider Demographics
NPI:1194903492
Name:DUGAN, JENNIFER ERIN (LCMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ERIN
Last Name:DUGAN
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 W NORTHERN PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1431
Mailing Address - Country:US
Mailing Address - Phone:410-433-3737
Mailing Address - Fax:410-433-8282
Practice Address - Street 1:1190 W NORTHERN PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1431
Practice Address - Country:US
Practice Address - Phone:410-433-3737
Practice Address - Fax:410-433-8282
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM216106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist