Provider Demographics
NPI:1245892090
Name:DUGGAN, RACHAEL (LPC)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 E LINCOLNWAY STE G
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-5671
Mailing Address - Country:US
Mailing Address - Phone:307-514-1288
Mailing Address - Fax:
Practice Address - Street 1:2710 THOMES AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3029
Practice Address - Country:US
Practice Address - Phone:307-200-7144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPPC-1249101Y00000X
101Y00000X, 172V00000X
WYLPC-2160101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health Worker