Provider Demographics
NPI:1225857295
Name:MCDONOUGH, ABIGAIL (LMSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9475 DEERECO RD STE 410
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2124
Mailing Address - Country:US
Mailing Address - Phone:410-560-6135
Mailing Address - Fax:410-560-6136
Practice Address - Street 1:9475 DEERECO RD STE 410
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2124
Practice Address - Country:US
Practice Address - Phone:410-560-6135
Practice Address - Fax:410-560-6136
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health