Julie Nicole Mulligan, CAC-ADP

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

ADT542 Issued in MD

Practice address

280 Stafford Rd
Prince Frederick, MD 20678-3582

Phone

(410) 535-3079

Fax

(410) 535-2220

NPI assigned

Jun 20, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Julie Nicole Bougtaugh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1649533001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206780980",
            "telephone_number": "410-535-3079",
            "fax_number": "410-535-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 STAFFORD RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783582",
            "telephone_number": "410-535-3079",
            "fax_number": "410-535-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "JULIE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "CAC-ADP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": "ADT542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "BOUGTAUGH",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "credential": "CAC-ADP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Morris-Deal, LCPC
• Dianna Lyn Mudd, RN
• Mukesh N Mathur,MD,PA.
• Michael J. Mulhearn, CRNA
• Doreen L Mullen, LGSW
• Anwar Munshi
• Michelle Munson, NP-C
• Rebecca Murphy, PA-C
• Taylor Nicole Mutchler
• Tia Luana Myers, LCPC

• Student in an Organized Health Care Education/Training Program in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Student in an Organized Health Care Education/Training Program in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.