Provider Demographics
NPI:1902935968
Name:DINGMAN, MARGUERITE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:DINGMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 WARD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1443
Mailing Address - Country:US
Mailing Address - Phone:919-493-7376
Mailing Address - Fax:919-493-7376
Practice Address - Street 1:1200 BROAD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3579
Practice Address - Country:US
Practice Address - Phone:919-493-7376
Practice Address - Fax:919-493-7376
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0024221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1285VOtherBLUE CROSS BLUE SHIELD
NC6002144Medicaid
NC2873439AMedicare ID - Type Unspecified