Individual
MATTHEW FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1025 VINEHAVEN DR NE, CONCORD, NC 28025-2439
(704) 918-1343
Mailing address
1025 VINEHAVEN DR NE, CONCORD, NC 28025-2439
(980) 866-0272
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A21759
NC
101YP2500X
Professional Counselor
Primary
A21759
NC
Other
Enumeration date
08/13/2025
Last updated
03/19/2026
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