| Doctor Name: | MR. ELMER FANGMAN |
| NPI Number: | 1417008657 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | LPC 0217 |
| Business Practice Address: | 1225 N 2nd St Atchison, KS - 660021401 |
| Business Phone Number: | 9133670105 |
| Business Fax Number: | 9133670105 |
| Mailing Address: | 1027 N 4th St, ATCHISON |
| State: | KS |
| Postal Code: | 660021407 |
| Phone Number: | 9133672688 |
| Fax Number: | |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC 0217 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |