ERIC WESLEY FADELY MA MA - NPI 1174819650 - Counselor in Cocoa Beach, FL

Q: What is Eric Fadely's NPI number?

The NPI number for Eric Fadely is 1174819650. It was assigned to this individual provider in the NPPES registry on June 23, 2011.

Q: What is Eric Fadely's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Eric Fadely was last updated on June 23, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Eric Wesley Fadely Ma Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERIC WESLEY FADELY MA MA (NPI 1174819650) is an individual mental health provider in Cocoa Beach, Florida, licensed in Florida (IMH 8755) and active in the NPI registry since June 2011.

NPPES Registry Identity

NPI1174819650

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameERIC WESLEY FADELYCredential: MA MA

Location Address3000 N ATLANTIC AVE STE 102Cocoa Beach, FL 32931-5045

Mailing Address3000 N Atlantic Ave Ste 102Cocoa Beach, FL 32931-5045 · (321) 784-5367 · Fax (321) 783-2290

Phone(321) 784-5367

Fax(321) 783-2290

Sole ProprietorYes

Enumeration DateJune 23, 2011

✔ NPI 1174819650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in FL · IMH 8755

3000 N ATLANTIC AVE STE 102, Cocoa Beach, FL 32931

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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARGARET MYERS PH.D. 7299

Counselor (Mental Health)