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

Primary practice address
59 Bayside Dr Palm Coast FL 32137-8871
Phone: (386) 986-8662
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447326475 NPPES
Florida MEDICAID 7660880 00
Florida MEDICAID 8117225 00

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