Fagan, Alicia Mary
Fagan, Alicia Mary is an individual health care provider with primary practice located at 51 North Main Street Ste 2C, Southington CT 06489. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Fagan, Alicia Mary can be contacted via phone (860) 621-2280.Contact Information
Primary practice address
51 North Main Street Ste 2C
Southington CT 06489
Phone: (860) 621-2280
Fax: (860) 628-0219
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 000422 | Connecticut |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 000618 | Connecticut |
Profile Details
| NPI number | 1629157615 |
|---|---|
| LBN Legal business name | Fagan, Alicia Mary |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2006 |
| Last updated | Jan 6th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629157615 | NPPES |
| Connecticut | MEDICAID | 004149531 |
Popular Providers
-
Badyrka, Kelly
96 Center St Suite 2C, Southington CT 06489-3108 -
Jameson, Albert W
333 Throckmorton St #909, Fort Worth TX 76102-7421 -
Lardner, Kevin
1783 Meriden Waterbury Turnpike Suite K 11, Southington CT 06489-0268 -
Carlin, Carl D
33 Varden Drive Sw , Aiken SC 29803 -
Sims, Tommye J
4334 Nw Expressway Suite 266, Oklahoma City OK 73116-1578 -
Binns, Patricia
5935 Us Highway 27 N #101, Sebring FL 33870-1200 -
Sims, Preston Lynn
4334 Nw Expressway Ste 266, Oklahoma City OK 73116-1578 -
Boaz, Delora K.
600 S Preston St , Louisville KY 40202-1716