Provider Demographics
NPI:1699148767
Name:DARGAKIS, FOULA (LGPC)
Entity type:Individual
Prefix:
First Name:FOULA
Middle Name:
Last Name:DARGAKIS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 FAIRMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-1308
Mailing Address - Country:US
Mailing Address - Phone:410-371-2967
Mailing Address - Fax:410-374-2657
Practice Address - Street 1:2298 FAIRMOUNT RD
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-1308
Practice Address - Country:US
Practice Address - Phone:410-371-2967
Practice Address - Fax:410-374-2657
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP6722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional