GLENN S. FAGEN PHD INC


Address: 100 King St, Suite 303, Northampton, MA 01060-3243
Phone: 4135848339

GLENN S. FAGEN PHD INC (NPI# 1518261874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518261874
Entity Type Organization
Organization Name GLENN S. FAGEN PHD INC
Practice Address 100 King St
Suite 303
Northampton
MA 01060-3243
Practice Telephone 4135848339
Practice Fax Number 4135848339
Mailing Telephone 4135848339
Mailing Fax Number 4135848807
Enumeration Date 2010-12-30
Last Update Date 2011-04-26
Authorized Official Name DR. GLENN SCOTT FAGEN (PRESIDENT)
Authorized Official Telephone 4135848339
Authorized Official Credential PHD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
6793 MA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MA BLUE CROSS AND BLUE SHIELD W05440 01
MA 0524484 05

Office Location

Street Address 100 KING ST
SUITE 303
City NORTHAMPTON
State MA
Zip Code 01060-3243

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457390015 Julia Feeney Social Worker 100 King St, Northampton, MA 01060-3243 2006-06-06
1245616606 Elise L Starr Social Worker 100 King St, Suite 203, Northampton, MA 01060-2581 2015-08-07
1659507689 Susan Stobierski Denny, PC Chiropractor 100 King St, Northampton, MA 01060-3243 2009-06-04
1932247475 Ann Cleaveland Social Worker 100 King St, Suite 203, Northampton, MA 01060-3243 2007-02-04
1811035983 Vivien Eva Weiss Specialist 100 King St, Northampton, MA 01060-3243 2007-02-02
1437204203 Robert Brandt, PC Psychologist 100 King St, Suite 202, Northampton, MA 01060-3243 2007-01-24
1922153774 Robert Brandt Psychologist 100 King St, Suite 202, Northampton, MA 01060-3243 2007-01-24
1497800221 Joan Swerdlow-brandt Social Worker 100 King St, Suite 202, Northampton, MA 01060-3243 2007-01-24
1003973017 Marjorie Ross Counselor 100 King St, Suite 303, Northampton, MA 01060-3243 2007-01-02
1376607580 Kristin Ann Grant Social Worker 100 King St, Northampton, MA 01060-3225 2006-12-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942869318 Stephanie Jordan Counselor 16 Center St Ste 517, Northampton, MA 01060 2019-06-10
1659853828 James Drisko Social Worker 159 Crescent St, Northampton, MA 01060 2018-09-04
1063994416 Nancy P Doby Social Worker 84 Conz Street, Northampton, MA 01060 2018-09-02
1356821144 Kathleen Ann Goodwin-boyd Social Worker Northampton High School, 380 Elm Street, Northampton, MA 01060 2018-08-21
1457847048 Kathryn Karusaitis Basham Social Worker 155 Main Street C/o Dr. Herzog Phd, Northampton, MA 01060 2018-07-06
1700392289 Angel Marie Kennedy Behavioral Analyst 351 Pleasant St Ste B126, Northampton, MA 01060 2017-12-20
1013437508 Ricky Jermaine Logan Counselor 129 North King Street, Northampton, MA 01060 2017-06-26
1962858886 Alicia Simoni Social Worker 25 Main St Ste 445, Northampton, MA 01060 2016-05-10
1134589708 James Edmonstone Clinic/Center 78 Mainst., Suite 404, Northampton, MA 01060 2016-02-25
1114395639 Danielle Baker Speech-Language Pathologist 228 King St Ste 2, Northampton, MA 01060 2015-09-15
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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1881088532 Trauma Institute & Child Trauma Institute, Inc Clinic/Center 320 Riverside Dr Ste 4, Northampton, MA 01062-2742 2015-03-20
1679056600 Alicia L. Simoni Psychotherapy, LLC Clinic/Center 25 Main St Ste 445, Northampton, MA 01060-3130 2018-09-14

Providers in the same taxonomy and state

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1497356513 Betterment Counseling Clinic/Center 556 Centre St Ste A, Middleboro, MA 02346-2162 2020-11-04
1962001651 Mindful Matters LLC Clinic/Center 12 Jarvis Ln, North Attleboro, MA 02760-4313 2020-10-22
1497353130 Handel Behavioral Health Services Clinic/Center 2 Master Dr Ste 1a, Franklin, MA 02038-3052 2020-10-14
1477167385 Hidden Gems Counseling LLC Clinic/Center 6 Liberty Sq, Pmb 452, Boston, MA 02109 2020-09-08
1710597406 Bridge of Changes Clinic/Center 215 Berkshire Ave, Springfield, MA 01109-1638 2020-08-06
1457969297 Starlight Counseling Services, Inc Clinic/Center 50 Elm St Unit D, Southbridge, MA 01550-2648 2020-07-17
1386262053 1a Wellness, LLC Clinic/Center 225 Main St Ste 4, Wenham, MA 01984-1459 2020-07-09
1528683596 Aviv, LLC Clinic/Center 511 Old Fall River Rd, Dartmouth, MA 02747-1208 2020-06-15
1447872130 Mindset Social Solutions Inc. Clinic/Center 79 Regis Rd Apt 1, Mattapan, MA 02126-1743 2020-05-15
1992325914 Al Counseling Clinic/Center 300 Baker Ave Ste 300, Concord, MA 01742-2124 2020-04-20
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Competitor

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City NORTHAMPTON
Zip Code 01060

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Dataset Information

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.

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