WILLAIM THOMAS FAGAN LPC
NPI 1588905319
Counselor - Professional in Bend, OR

NPI Status: Active since March 04, 2013

Contact Information

1569 SW NANCY WAY
BEND, OR
ZIP 97702
Phone: (541) 617-0377
Fax: (541) 617-0377

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  • Individual
  • Male
  • Counselor
  • Professional
  • Accepts Insurance
  • Opted-Out Medicare

About WILLAIM FAGAN

This page provides the complete NPI Profile along with additional information for Willaim Fagan, a provider established in Bend, Oregon with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1588905319 assigned on March 2013. The practitioner's primary taxonomy code is 101YP2500X with license number C4302 (OR). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1588905319
Provider Name
WILLAIM THOMAS FAGAN LPC
Gender
Male
Entity Type
Individual
Location Address
1569 SW NANCY WAY BEND, OR 97702
Location Phone
(541) 617-0377
Location Fax
(541) 617-0377
Mailing Address
3616 SW REINDEER AVE REDMOND, OR 97756
Mailing Phone
(541) 508-9593
Is Sole Proprietor?
No
Enumeration Date
03-04-2013
Last Update Date
08-15-2019
Code Navigator



The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Willaim Fagan opted out of Medicare effective on 10-31-2024 until 10-31-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Secondary Locations

  • 676 NE Negus Way
    Redmond, OR 97756
    (541) 516-4087
  • 339 SW Century Dr Ste 201
    Bend, OR 97702
    (541) 508-9593

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Professional

Taxonomy Code
101YP2500X
Type
Behavioral Health & Social Service Providers
License No.
C4302
License State
OR

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101YA0400XBehavioral Health & Social Service Providers

Counselor
Addiction (Substance Use Disorder)

R2719 (OR)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Bronze 8000 Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
  • Bronze HSA 7000 Individual Connect - EPO
  • Gold 2300 Individual Connect - EPO
  • Regence Standard Bronze Plan Individual Connect - EPO
  • Regence Standard Gold Plan Individual Connect - EPO
  • Regence Standard Silver Plan Individual Connect - EPO
  • Silver 6500 Individual Connect - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 10-31-2024

  • Opt-Out End Date: 10-31-2026

  • Eligible to Order and Refer? No

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1588905319, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
8
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
0
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
1
Doubled → 2
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 9 → 18 → 9 5 → 10 → 1 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 6 + 8 + 1 + 8 + 0 + 1 + 0 + 3 + 2 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1588905319.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Massage Therapist
1569 SW NANCY WAY, SUITE 1
BEND, OR 97702
Dentist (Periodontics)
1569 SW NANCY WAY, LOWER LEVEL
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY, SUITE 1
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY, SUITE 1
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Chiropractor (Nutrition)
1569 SW NANCY WAY, SUITE 1
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Professional)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702
Counselor (Mental Health)
1569 SW NANCY WAY
BEND, OR 97702

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1588905319, enumerated as an "individual" on March 04, 2013.

The provider is located at 1569 SW NANCY WAY BEND, OR 97702 and the phone number is (541) 617-0377.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: BridgeSpan Health Company and Regence BlueCross. Please consult your insurance carrier or call the provider to verify.