Fagan, Stephanie A
Fagan, Stephanie A is an individual health care provider with primary practice located at 1006 N Main Street , Dayville CT 06241-2170. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fagan, Stephanie A can be contacted via phone (860) 774-2020.Contact Information
Primary practice address
1006 N Main Street
Dayville CT 06241-2170
Phone: (860) 774-2020
Fax: (860) 779-5437
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LC50081357 | District of Columbia |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1237 | Connecticut |
Profile Details
| NPI number | 1679839997 |
|---|---|
| LBN Legal business name | Fagan, Stephanie A |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2012 |
| Last updated | Jun 8th, 2017 - about 9 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 | 1679839997 | NPPES |
| Connecticut | MEDICAID | 004040564 |
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