Active NPI
Nancy J Fagan
- Clinical Social Worker
- Lowell, MA
National Provider Identifier
1063759272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1020260
- Practice address
- 10 Bridge St
Simpson Block
Lowell, MA 01852-1268 - Phone
- (978) 453-5736
- NPI assigned
- Jan 8, 2013
- Last updated
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1020260 | MA | Primary |
Addresses
Primary practice location
10 Bridge St
Simpson Block
Lowell, MA 01852-1268
Mailing address
10 Bridge St
Simpson Block
Lowell, MA 01852-1268
Phone (978) 453-5736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1020260 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357603200000",
"number": "1063759272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 BRIDGE ST",
"address_2": "SIMPSON BLOCK",
"city": "LOWELL",
"state": "MA",
"postal_code": "018521268",
"telephone_number": "978-453-5736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 BRIDGE ST",
"address_2": "SIMPSON BLOCK",
"city": "LOWELL",
"state": "MA",
"postal_code": "018521268",
"telephone_number": "978-453-5736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "NANCY",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2013-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1020260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.