Fagan, Colleen
Fagan, Colleen is an sole proprietor health care provider with primary practice located at 2900 Ne 60Th St Ste 205 , Gladstone MO 64119-2091. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fagan, Colleen can be contacted via phone (816) 694-0200.Contact Information
Primary practice address
2900 Ne 60Th St Ste 205
Gladstone MO 64119-2091
Phone: (816) 694-0200
Fax: (888) 507-5906
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 36586 | Texas |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2014016577 | Missouri |
Profile Details
| NPI number | 1972915379 |
|---|---|
| LBN Legal business name | Fagan, Colleen |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 20th, 2014 |
| Last updated | Sep 28th, 2022 - about 2 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 | 1972915379 | NPPES |
| Missouri | Other | 2014016577 | LICENSE # |
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