Patrick L Fagan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1234 Pearl St
Suite 3
Eugene, OR 97401-3642

Phone

(541) 968-7424

NPI assigned

Jul 17, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1497954580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 BOBOLINK AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974041513",
            "telephone_number": "541-607-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 PEARL ST",
            "address_2": "SUITE 3",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013642",
            "telephone_number": "541-968-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "PATRICK",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyemart Express, LTD.
• Amaelo Ezeonwuka, LPC
• Karaine Eziolisa, RN
• Kathy S Faber, FNP
• Takayo Fackrell
• Patricia Faye Fagundes
• Patricia A. Fahlstrom-Nopp, RD
• Jason Fair
• David L Fairbanks, RPH
• Lindsay Fairchild, LMFT

• Clinical Social Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.