Provider Demographics
NPI:1912545443
Name:HAGER, MORIAH FAY (LPC)
Entity type:Individual
Prefix:
First Name:MORIAH
Middle Name:FAY
Last Name:HAGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E 33RD AVE UNIT 5851
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-0838
Mailing Address - Country:US
Mailing Address - Phone:541-937-5435
Mailing Address - Fax:
Practice Address - Street 1:30 E 33RD AVE UNIT 5851
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-0838
Practice Address - Country:US
Practice Address - Phone:541-937-5435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC6490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC6490OtherOREGON BOARD OF LICENSE PROFESSIONAL COUNSELORS AND THERAPISTS