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NPI Code Detail

MEDICARE: DR. DEIRDRE ANNE GAUGHAN PSYD

MEDICARE: DR. DEIRDRE ANNE GAUGHAN PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPSY200001385DC
2103T00000XPsychologist0810007810VA

General Provider Information

NPI Number : 1154088557
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEIRDRE ANNE GAUGHAN PSYD
Provider Business Mailing Address
First Line : 1350 CONNECTICUT AVE NW STE 500
Second Line :
City : WASHINGTON
State : DC
Zip : 20036-1736
Country : US
Telephone Number : 240-244-7152
Fax Number :
Provider Business Practice Location Address
First Line : 1350 CONNECTICUT AVE NW STE 500
Second Line :
City : WASHINGTON
State : DC
Zip : 20036-1736
Country : US
Telephone Number : 914-260-0727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2021
Last Update Date : 04/20/2026

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