MRS. SUSAN MARIE FAGAN (NPI# 1043468556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043468556 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN MARIE FAGAN |
| Credential | L.P.C., R.N. |
| Practice Address |
12125 Woodcrest Executive Dr Suite 110 Saint Louis MO 63141-5001 |
| Mailing Address |
10820 Sunset Office Dr Suite 122 Saint Louis MO 63127-1016 |
| Practice Telephone | 3142758599 |
| Mailing Telephone | 3149546553 |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-10-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
2004032923 | MO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699110536 | Susan C. Fagan | Registered Nurse | 1040 Chevelle Dr, Baton Rouge, LA 70806-7805 | 2013-05-06 |
| 1316276033 | Susan Christine Fagan | Pharmacist | Hm 1220 1120 15th Street, University of Georgia College of Pharmacy, Augusta, GA 30912 | 2009-12-08 |
| 1851594899 | Susan Michelle Fagan | Social Worker | 185 Center Street Suite B, Wallingford, CT 06492 | 2007-06-07 |
| 1891858742 | Susan Millie Fagan | Dentist | 5281 Lapeer Road, Kimball, MI 48074 | 2006-12-19 |
| 1922078351 | Susan Fagan | Physical Therapist | 1 Emily Way, West Hartford, CT 06107-3136 | 2006-01-26 |
| 1972963684 | Susan Fagan | Behavioral Analyst | 6 Southside Rd, Danvers, MA 01923-1409 | 2016-02-24 |
| 1568781086 | Susan Fagan | Occupational Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2010-05-24 |
| Street Address |
12125 WOODCREST EXECUTIVE DR SUITE 110 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-5001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194779579 | Inpatient Consultants of Missouri Inc | Hospitalist | 12125 Woodcrest Executive Dr, Suite 220, Saint Louis, MO 63141-5001 | 2006-05-20 |
| 1558806422 | Anthony Michael Tramelli | Counselor | 12125 Woodcrest Executive Dr, Suite 110, Saint Louis, MO 63141-5001 | 2016-12-30 |
| 1225400427 | Kathleen Taggart | Social Worker | 12125 Woodcrest Executive Dr, Suite 110, Saint Louis, MO 63141-5001 | 2015-10-27 |
| 1811389661 | Amy Vanessa Maus | Social Worker | 12125 Woodcrest Executive Dr, Saint Louis, MO 63141-5001 | 2015-03-02 |
| 1033531207 | Amy Kelly Neu | Social Worker | 12125 Woodcrest Executive Dr, Suite 110, Saint Louis, MO 63141-5001 | 2014-01-07 |
| 1619304250 | Jennifer Webbe Van Luven | Social Worker | 12125 Woodcrest Executive Dr, Suite 110, Saint Louis, MO 63141-5001 | 2013-09-27 |
| 1184962623 | Murisa Begic-gusic | Psychologist | 12125 Woodcrest Executive Dr, Suite 110, Saint Louis, MO 63141-5001 | 2013-01-17 |
| 1225331002 | Inpatient Consultants of Kansas Pa | Family Medicine | 12125 Woodcrest Executive Dr, 220, Saint Louis, MO 63141-5001 | 2010-12-16 |
| 1861795635 | Inpatient Consultants of Kansas Pa | Family Medicine | 12125 Woodcrest Executive Dr, 220, Saint Louis, MO 63141-5001 | 2010-12-16 |
| 1861792723 | Fitzgibbons Psychological West County Psychological Associates | Psychologist | 12125 Woodcrest Executive Dr, Saint Louis, MO 63141-5001 | 2010-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736588 | Roberta Kerosevic | Counselor | 12203 Big Bend Rd Ste 101, Saint Louis, MO 63122-6848 | 2020-10-08 |
| 1528665726 | Kimberly Cappetta | Counselor | 4567 W Pine Blvd Apt 710, Saint Louis, MO 63108-2192 | 2020-10-01 |
| 1508475534 | Elizabeth (lisa) Pullen Will-smith | Counselor | 6649 Hoffman Ave, Saint Louis, MO 63139-2546 | 2020-07-27 |
| 1689297970 | Joy Montrice Camp | Counselor | 1126 N 16th St, Saint Louis, MO 63106-3736 | 2020-05-21 |
| 1568084622 | Amy Turk | Counselor | 701 Luckystone Ave, Saint Louis, MO 63122-3245 | 2020-05-12 |
| 1588285647 | Jesse Sieger-walls | Counselor | 32 Bellerive Acres, Saint Louis, MO 63121-4321 | 2020-04-29 |
| 1265061394 | Victoria Kyles | Counselor | 124 Forestwood Dr, Saint Louis, MO 63135-2827 | 2020-04-01 |
| 1790312528 | Sarah Williford | Counselor | 8420 Delmar Blvd Ste 301, Saint Louis, MO 63124-2178 | 2020-03-23 |
| 1033745005 | Casey Robert Thompson | Counselor | 600 Buckley Rd, Saint Louis, MO 63125-5303 | 2020-03-20 |
| 1891328613 | Jessica Kay Dowling | Counselor | 3008 Sutton Blvd Ste 200, Saint Louis, MO 63143-3064 | 2020-02-20 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on MRS. SUSAN MARIE FAGAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.