Fagin, Susan Mary

Fagin, Susan Mary is an individual health care provider with primary practice located at 565 Union St Ne Ste 100 , Salem OR 97301-2416. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Behavior Technician, Other Service Providers / Contractor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Fagin, Susan Mary can be contacted via phone (971) 719-2440.

Contact Information

Primary practice address
565 Union St Ne Ste 100 Salem OR 97301-2416
Phone: (971) 719-2440
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Other Service Providers / Contractor 171W00000X 9215 Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1730404567
LBN Legal business name Fagin, Susan Mary
Credentials MENTAL HEALTH COUNSE
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2010
Last updated Oct 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730404567 NPPES
Oregon MEDICAID 01YM0800X-
Oregon MEDICAID 0LYM0800X

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