Healthcare Provider Details

I. General information

NPI: 1548256795
Provider Name (Legal Business Name): KEVIN PATRICK DUGAN PHD, HSPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 ALBRIGHT RD
KOKOMO IN
46902-3996
US

IV. Provider business mailing address

2751 ALBRIGHT RD STE 375
KOKOMO IN
46902-3996
US

V. Phone/Fax

Practice location:
  • Phone: 765-450-4843
  • Fax: 765-450-4895
Mailing address:
  • Phone: 765-450-4843
  • Fax: 765-450-4895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number20041836A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: