Sand R. Bagoon, PH.D., PA

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

02686 Issued in MD

Legal business name

SAND R. BAGOON, PH.D., PA

Practice address

3355 Saint Johns LN
Suite F
Ellicott City, MD 21042-2605

Phone

(410) 781-7263

NPI assigned

Feb 5, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Sand Royce Bagoon, PH.D.

Title

Licensed Psychologist

Phone

(410) 781-7263

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1296864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296864000000",
    "number": "1780980912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 GUILFORD RD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217848862",
            "telephone_number": "410-781-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 SAINT JOHNS LN",
            "address_2": "SUITE F",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422605",
            "telephone_number": "410-781-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAND R. BAGOON, PH.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-05",
        "last_updated": "2011-02-05",
        "status": "A",
        "authorized_official_last_name": "BAGOON",
        "authorized_official_first_name": "SAND",
        "authorized_official_middle_name": "ROYCE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "410-781-7263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MD",
            "license": "02686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Anthony Sambataro, DDS
• Julia Telles Sampaio, LMSW
• Denise Sample, P.T.A.
• Samuel Berkowitz, PH.D., Inc.
• Stacey Samuels Cole, AU.D.
• Jamie Sandbank
• Jessica Sanders
• Benjamin Alan Sandler, D.D.S.
• Sandra Gail Sattin MD LLC
• Alexandra Higgins Sanet, CCC-SLP

• Counseling Psychologist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Counseling Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2011; 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.