Terese Fagan LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008738 Issued in CT

Legal business name

TERESE FAGAN LCSW LLC

Practice address

45 S Main St
Suite 107
West Hartford, CT 06107-2441

Phone

(860) 778-3304

NPI assigned

Oct 4, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terese Ballet

Title

Licensed Clinical Social Worker

Phone

(860) 778-3304

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terese Fagan, LCSW

  • Clinical Social Worker
  • West Hartford, CT
  • NPI 1023568961
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1063962900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 TOLLAND TPKE",
            "address_2": "UNIT 258",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST",
            "address_2": "SUITE 107",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072441",
            "telephone_number": "860-778-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESE FAGAN LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "BALLET",
        "authorized_official_first_name": "TERESE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "860-778-3304"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Tedesco
• Michael B Teiger, MD
• Silvana Ann Tellerico, AUD.
• Tenacity Behavioral Health LLC
• Suzanne M Tenser, M.D.
• Elisheva Esther Terrion, ND
• Sejal Thacker, DDS
• The Bridge Family Center
• The Bridge Family Center
• The Bridge Family Center

• Clinical Social Worker in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.