Pamela Fagan is a Mental Health in Boise, Idaho. Pamela Fagan practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Pamela Fagan is 1104093061. The last update date is 2011-02-22.
Pamela Fagan's current location address is 13599 W Elmspring St, Boise, Idaho. You can contact this provider via phone number 2087248598. The mailing address for Pamela Fagan is 13599 W Elmspring St, Boise, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Pamela Fagan |
|---|---|
| Address | 13599 W Elmspring St, Boise, Idaho |
| Phone Number | 2087248598 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.A., LCPC |
NPI Number Detail
| NPI Number | 1104093061 |
|---|---|
| Provider Enumeration Date | 2008-05-09 |
| Last Updated Date | 2011-02-22 |
Provider Mailing Address Detail
| Address | 13599 W Elmspring St |
|---|---|
| City | Boise |
| State | Idaho (ID) |
| Post Code | 837131389 |
| Phone Number | 2087248598 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | LCPC-4674 |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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What is the unique identification code assigned to Pamela Fagan by the Centers for Medicare & Medicaid Services?
The Pamela Fagan has been issued the NPI (National Provider Identifier) 1104093061. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Pamela Fagan's physical address?
The Pamela Fagan is physically located at 13599 W Elmspring St, in the city of Boise, ID, with the postal code 837131389.
What is Pamela Fagan's specialized field of practice, and what is the corresponding taxonomy classification code?
The Pamela Fagan's area of specialization is Mental Health, and the corresponding taxonomy code that categorizes this field of practice is 101Ym0800X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1104093061 to Pamela Fagan?
The Centers for Medicare & Medicaid Services originally issued the 1104093061 to Pamela Fagan on 2008-05-09.
As of what date were the details pertaining to Pamela Fagan last refreshed?
The information related to the Pamela Fagan, including its address, specialty, and other relevant details, was last updated on 2011-02-22.