Provider Demographics
NPI:1861176216
Name:CAUGHLAN, IAN (LMSW)
Entity type:Individual
Prefix:MR
First Name:IAN
Middle Name:
Last Name:CAUGHLAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 OAKLAND MILLS RD STE 140
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2270
Mailing Address - Country:US
Mailing Address - Phone:443-842-4149
Mailing Address - Fax:
Practice Address - Street 1:7050 OAKLAND MILLS RD STE 140
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2270
Practice Address - Country:US
Practice Address - Phone:443-842-4149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29961104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker