Provider Demographics
NPI:1972938629
Name:BAGANA, RACHID (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:RACHID
Middle Name:
Last Name:BAGANA
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13906 CASTLE BLVD APT 304
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4943
Mailing Address - Country:US
Mailing Address - Phone:205-410-0456
Mailing Address - Fax:
Practice Address - Street 1:13906 CASTLE BLVD APT 304
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4943
Practice Address - Country:US
Practice Address - Phone:205-410-0456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD193771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical