Fay, Richard A
Fay, Richard A is an sole proprietor health care provider with primary practice located at 59 Bayside Dr , Palm Coast FL 32137-8871. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Fay, Richard A can be contacted via phone (386) 986-8662.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | Florida | |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW8489 | Florida |
Profile Details
| NPI number | 1447326475 |
|---|---|
| LBN Legal business name | Fay, Richard A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Aug 2nd, 2017 - about 8 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 | 1447326475 | NPPES |
| Florida | MEDICAID | 7660880 00 | |
| Florida | MEDICAID | 8117225 00 |
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