Clougherty, Brian P

Clougherty, Brian P is an sole proprietor health care provider with primary practice located at 4324 S Alston Ave Ste 203 , Durham NC 27713-5296. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Clougherty, Brian P can be contacted via phone (919) 806-0009.

Contact Information

Primary practice address
4324 S Alston Ave Ste 203 Durham NC 27713-5296
Phone: (919) 806-0009
Fax: (919) 806-1201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Pastoral 101YP1600X
Behavioral Health & Social Service Providers / Professional 101YP2500X 7391 North Carolina

Profile Details

NPI number 1548402738
LBN Legal business name Clougherty, Brian P
Credentials M.A., M.DIV., LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 2nd, 2009
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548402738 NPPES
North Carolina MEDICAID 6104213

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