Individual provider · Type 1 NPI
Alicia Mary Fagan, LCSW
Addiction (Substance Use Disorder) Counselor · Southington, CT
NPI number
1629157615
Active
Practice location
51 North Main Street, Ste 2C
Southington, CT 06489
Fax (860) 628-0219
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 000422 (CT) |
| Clinical Social Worker | 1041C0700X | 000618 (CT) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Other addiction (substance use disorder) counselor providers in Southington
About NPI 1629157615
Alicia Mary Fagan, LCSW's National Provider Identifier is 1629157615, issued on Nov 2, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Southington, CT. The record was last updated on Jan 6, 2012.