Leigh Anne Fagin, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4365C Issued in AL

Practice address

7125 University CT
Montgomery, AL 36117-8016

Phone

(334) 239-2622

NPI assigned

Oct 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gardenia Cove Mental Health PCGroup PAC ID 0648534537, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gardenia Cove Mental Health PC

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1063912301
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1114568508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 UNIVERSITY CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178016",
            "telephone_number": "334-239-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 UNIVERSITY CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178016",
            "telephone_number": "334-239-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGIN",
        "first_name": "LEIGH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4365C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Partners, PC
• Eyecare Associates, Inc.
• Eyemart Express LLC
• Eyemart Express, LTD.
• Oluwatoyin Fadare
• Kendra Fails
• Kimyatta Greathouse Fails, LPC,NCC,CAC
• Jordan Fain
• Maranda Jaran Fain, CRNP
• Tiffany Fair

• Clinical Social Worker in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.