1306564620 NPI number — MR. JOEL MATTHEW FINEGAN MS, LPC, CRC, NCC

Table of content: MR. JOEL MATTHEW FINEGAN MS, LPC, CRC, NCC (NPI 1306564620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306564620 NPI number — MR. JOEL MATTHEW FINEGAN MS, LPC, CRC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINEGAN
Provider First Name:
JOEL
Provider Middle Name:
MATTHEW
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS, LPC, CRC, NCC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306564620
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9170 SAGEWOOD DR APT 5204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76177-2346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-571-4418
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2660 SCRIPTURE ST STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76201-4343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-315-7825
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/22/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
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Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  85103 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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