Provider Demographics
NPI:1972024032
Name:JANGULA, LOGAN (LCAC/LPCC)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:JANGULA
Suffix:
Gender:M
Credentials:LCAC/LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1286
Mailing Address - Street 2:
Mailing Address - City:WATFORD CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58854-1286
Mailing Address - Country:US
Mailing Address - Phone:701-586-3300
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1286
Practice Address - Street 2:
Practice Address - City:WATFORD CITY
Practice Address - State:ND
Practice Address - Zip Code:58854-1286
Practice Address - Country:US
Practice Address - Phone:701-586-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)