| Doctor Name: | NICHOLAS GAUGHAN |
| NPI Number: | 1093071136 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LADC |
| License Number: | 001066 |
| Business Practice Address: | 37 Commerce Ave Danielson, CT - 062392804 |
| Business Phone Number: | 8607747179 |
| Business Fax Number: | 7607796526 |
| Mailing Address: | 37 Commerce Ave, DANIELSON |
| State: | CT |
| Postal Code: | 062392804 |
| Phone Number: | 8607747179 |
| Fax Number: | 7607796526 |
| NPI Enumeration Date: | 04/03/2012 |
| NPI Last Update Date: | 12/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 001066 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |