Active NPI
Gerald M Dugal, EDD
- Clinical Psychologist
- Andover, MA
National Provider Identifier
1104866326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1090
- Practice address
- 8 Theodore Avenue
Andover, MA 01810 - Phone
- (978) 475-3501
- Fax
- (978) 837-5209
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1090 | MA | Primary |
Addresses
Primary practice location
8 Theodore Avenue
Andover, MA 01810
Mailing address
8 Theodore Avenue
Andover, MA 01810
Phone (978) 475-3501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1090 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1104866326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 THEODORE AVENUE",
"city": "ANDOVER",
"state": "MA",
"postal_code": "01810",
"telephone_number": "978-475-3501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 THEODORE AVENUE",
"city": "ANDOVER",
"state": "MA",
"postal_code": "01810",
"telephone_number": "978-475-3501",
"fax_number": "978-837-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUGAL",
"first_name": "GERALD",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "EDD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "1090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.