Amber Fagan, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BH006068 Issued in PA

Practice address

961 Marcon Blvd Ste 312
Allentown, PA 18109-9373

Phone

(610) 266-0610

NPI assigned

Aug 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Glenn R. Koch & Associates, LLC

  • Counseling Psychologist
  • Allentown, PA
  • NPI 1093122699

  Multi-Specialty

  NPD
• Glenn R Koch and Associates Inc

  • Psychiatry Physician
  • Allentown, PA
  • NPI 1700949161

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1660348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660348800000",
    "number": "1902534217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E ETTWEIN ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180182808",
            "telephone_number": "484-634-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 MARCON BLVD STE 312",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181099373",
            "telephone_number": "610-266-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "AMBER",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-13",
        "last_updated": "2022-08-13",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH006068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale James Ezrow, LCSW
• Michele Post Ezrow, LCSW
• Mary Patricia Fabian, M.D.
• Sunshine Fachet, MS OTR/L
• Hagar Fadel
• Kara Rose Fagerstrom, PAC
• Ellen Fairchild
• Fairmont Dental Associates PC
• Fairmont Medical Center, LLC
• Ali Fakhimi

• Behavior Analyst in Allentown, PA
• Providers in Allentown, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2022; 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.