Healthcare Provider Details

I. General information

NPI: 1164348850
Provider Name (Legal Business Name): MARY C DUGGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CARLISLE ST STE 203
HANOVER PA
17331-2472
US

IV. Provider business mailing address

101 PEMBROKE CT
GREENSBURG PA
15601-6404
US

V. Phone/Fax

Practice location:
  • Phone: 724-396-1510
  • Fax: 724-972-6472
Mailing address:
  • Phone: 724-396-1510
  • Fax: 724-972-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC002510
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: