SAND R. BAGOON, PH.D., PA (NPI# 1780980912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780980912 |
| Entity Type | Organization |
| Organization Name | SAND R. BAGOON, PH.D., PA |
| Practice Address |
3355 Saint Johns Ln Suite F Ellicott City MD 21042-2605 |
| Mailing Address |
1263 Guilford Rd Eldersburg MD 21784-8862 |
| Practice Telephone | 4107817263 |
| Mailing Telephone | 4107817263 |
| Enumeration Date | 2011-02-05 |
| Last Update Date | 2011-02-05 |
| Authorized Official Name | DR. SAND ROYCE BAGOON (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 4107817263 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
02686 | MD | Behavioral Health & Social Service Providers |
| Street Address |
3355 SAINT JOHNS LN SUITE F |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21042-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285617506 | Jeffrey Soulen | Psychiatry & Neurology | 3355 Saint Johns Ln, Ste F, Ellicott City, MD 21042-2605 | 2005-11-21 |
| 1831634450 | Ccb Partners LLC | Community/Behavioral Health | 3355 Saint Johns Ln, Suite J, Ellicott City, MD 21042-2605 | 2017-01-05 |
| 1578977930 | Cheryl Confer | Counselor | 3355 Saint Johns Ln, J, Ellicott City, MD 21042-2605 | 2014-06-13 |
| 1346662038 | Jermany and Associates, P.a. | Psychiatry & Neurology | 3355 Saint Johns Ln, Suite F, Ellicott City, MD 21042-2605 | 2014-01-14 |
| 1316224231 | Kara Mia Biondo | Psychologist | 3355 Saint Johns Ln, Suite F, Ellicott City, MD 21042-2605 | 2011-11-06 |
| 1407134067 | Ruth Prendergast Dennison-tedesco | Counselor | 3355 Saint Johns Ln, St John's Professional Center Suite F, Ellicott City, MD 21042-2605 | 2011-08-01 |
| 1801037015 | Carmen Miles Davis | Social Worker | 3355 Saint Johns Ln, Ste F, Ellicott City, MD 21042-2600 | 2009-03-18 |
| 1245438472 | Dr. Sung S. Han's Psychological and Educational Services, PC | Psychologist | 3355 Saint Johns Ln, Suite F, Ellicott City, MD 21042-2605 | 2007-07-10 |
| 1831215292 | Kim D Moss | Psychologist | 3355 Saint Johns Ln, Ste F, Ellicott City, MD 21042-2605 | 2007-03-21 |
| 1235263559 | Mertine R. Jermany | Psychiatry & Neurology | 3355 Saint Johns Ln, Suite F, Ellicott City, MD 21042-2605 | 2007-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861950792 | Danielle Coliukos | Student in an Organized Health Care Education/Training Program | 3006 Fawnwood Dr, Ellicott City, MD 21042 | 2019-03-11 |
| 1700356110 | Sung Hee Moon | Acupuncturist | 9005 Chevrolet Dr #4, Ellicott City, MD 21042 | 2018-11-28 |
| 1902375009 | Sharon N Allen | Speech-Language Pathologist | Hcpss, 10910 Clarksville Pike, Ellicott City, MD 21042 | 2018-11-19 |
| 1043700412 | Samirawit Hailemariam | Registered Nurse | 9527 Liverpool Lane, Ellicott City, MD 21042 | 2018-05-11 |
| 1144771965 | Maryland Psychotherapy Services | Community/Behavioral Health | 7054 Dorsey Hall Dr., Suite 104, Ellicott City, MD 21042 | 2016-10-17 |
| 1861851321 | The Lutheran Village At Miller's Grant, Inc. | Skilled Nursing Facility | 9000 Fathers Legacy, Ellicott City, MD 21042 | 2016-02-12 |
| 1942676952 | Hyoung Keun Kim | Dentist | 10033 Baltimore Pike Suite 320, Ellicott City, MD 21042 | 2015-08-13 |
| 1356743553 | Cvs Pharmacy | Pharmacist | 3300a Centennial Lane, Ellicott City, MD 21042 | 2014-09-18 |
| 1821407719 | Zulema Roberts | Counselor | 3355 St. Johns Lane, Suite F, Ellicott City, MD 21042 | 2014-08-05 |
| 1548681638 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 3459 St. John's Lane, Suite 9, Ellicott City, MD 21042 | 2013-12-17 |
| Find all providers in zip 21042 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326318833 | Arti Malhotra Abramovitz | Psychologist | 5473 Hunting Horn Dr, Ellicott City, MD 21043-7061 | 2012-01-01 |
| 1538219555 | Chanda Carmela Corbett | Psychologist | 3545 Ellicott Mills Dr, Suite 101, Ellicott City, MD 21043-4548 | 2007-01-11 |
| 1740302926 | Scott Eric Alpert | Psychologist | 8659 Baltimore National Pike, Suite M, Ellicott City, MD 21043-4126 | 2007-04-06 |
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|---|---|---|---|---|
| 1154947422 | Kathryn Victoria Kline | Psychologist | 8137 Greenbelt Station Pkwy, Greenbelt, MD 20770-4077 | 2020-06-22 |
| 1801412333 | At The Top Wellness, LLC | Psychologist | 8775 Centre Park Dr # M763, Columbia, MD 21045-2177 | 2020-06-20 |
| 1154942936 | Heather Ganginis Delpino | Psychologist | 5 Horizon Ct, Derwood, MD 20855-1347 | 2020-05-03 |
| 1194356717 | Kristin Sagun | Psychologist | 3901 National Drive, Suite #100, Burtonsville, MD 20866 | 2020-02-02 |
| 1790325512 | Step of Faith, LLC | Psychologist | 6302 N Point Rd Unit C, Sparrows Point, MD 21219-1040 | 2020-01-09 |
| 1598301608 | Tymesha Anita Savoy | Psychologist | 5210 Carswell Ave, Camp Springs, MD 20746-3941 | 2019-11-24 |
| 1235772575 | Covenant Psychiatric and Mental Health Services, LLC | Psychologist | 8507 Oxon Hill Rd # S200-4, Fort Washington, MD 20744-4766 | 2019-10-18 |
| 1033763214 | Relational Excellence, LLC | Psychologist | 898 Airport Park Rd Ste 101, Glen Burnie, MD 21061-2521 | 2019-07-26 |
| 1285299750 | Danita Wynes | Psychologist | 8737 Colesville Rd Ste 801, Silver Spring, MD 20910-3968 | 2019-05-09 |
| 1609337021 | Tyler James Howard | Psychologist | 8600 Lasalle Road Carroll Building, Suite 212, Towson, MD 21286 | 2019-03-28 |
| Find all providers with the same taxonomy | ||||
| City | ELLICOTT CITY |
| Zip Code | 21042 |
Please comment or provide details below to improve the information on SAND R. BAGOON, PH.D., PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.