Individual provider Active NPI

Emily Fagan, LPC

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1770179152
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C7728 Issued in OR
Practice address
9201 SE Foster Rd Ste 205&206
Portland, OR 97266-4644
Phone
(503) 549-4714
Fax
(503) 506-0441
NPI assigned
Dec 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C7728 OR Primary

Addresses

Primary practice location

9201 SE Foster Rd Ste 205&206
Portland, OR 97266-4644

Mailing address

PO Box 90309
Portland, OR 97290-0309
Phone (503) 549-4714

Other practice location 1

959 SE Division St Ste 520
Portland, OR 97214-4672
Phone (503) 549-4714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C7728ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightways Counseling Group LLC CurrentSince Apr 27, 2025 Accepting new patients
Bright Horizons Psychiatric Group LLC CurrentSince Apr 27, 2025 Accepting new patients
Second Growth Counseling LLC Professional PastSince Aug 6, 2023 Accepting new patients

Locations

2901 E Burnside St
Portland, OR 97214
Phone (503) 230-9875

7515 Falcon Crest Dr
#200
Redmond, OR 97756

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1770179152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90309",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972900309",
            "telephone_number": "503-549-4714",
            "fax_number": "503-506-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 SE FOSTER RD STE 205&206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664644",
            "telephone_number": "503-549-4714",
            "fax_number": "503-506-0441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "959 SE Division St Ste 520",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972144672",
            "country_code": "US",
            "telephone_number": "503-549-4714",
            "fax_number": "503-506-0441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "EMILY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C7728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.