Fagan, Willaim Thomas

Fagan, Willaim Thomas is an individual health care provider with primary practice located at 1569 Sw Nancy Way , Bend OR 97702-3234. He 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 / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Fagan, Willaim Thomas can be contacted via phone (541) 617-0377.

Contact Information

Primary practice address
1569 Sw Nancy Way Bend OR 97702-3234
Phone: (541) 617-0377
Fax: (541) 617-0377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X R2719 Oregon
Behavioral Health & Social Service Providers / Professional 101YP2500X C4302 Oregon

Profile Details

NPI number 1588905319
LBN Legal business name Fagan, Willaim Thomas
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2013
Last updated Aug 15th, 2019 - about 7 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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