Nathan Fanton, LICSW

Individual provider Active NPI Clinical Social Worker · Manchester, MA

NPI 1376186353 · NPPES record last updated Apr 2, 2025

Key facts

NPI
1376186353
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LICSW1121303 (MA)
Practice address
76 Summer St FL 2
Manchester, MA 01944-1530
Phone
(978) 915-2520
Fax
(978) 915-2521
NPI assigned
Oct 23, 2019
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

76 Summer St
FL 2
Manchester, MA 01944-1530
Phone (978) 915-2520

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250313002055 MA Practitioner - Clinical Social Worker 5799207205 Practice locations: Manchester, MA

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LICSW1121303MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fanton Consulting, Inc. Clinical Current
since Feb 9, 2025
Accepting new patients
Boston Psychotherapy & Counseling Services Inc Social Worker Current Accepting new patients

Locations

90 Canal St
Ste 4
Boston, MA 02114
Phone (617) 517-4889

90 Canal St
Ste 459
Boston, MA 02114
Phone (617) 520-4783

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW1121303 MA Yes

Addresses

Primary practice location

76 Summer St FL 2
Manchester, MA 01944-1530

Mailing address

PO Box 173
Manchester, MA 01944-0173
Phone (978) 915-2520

Other providers in Manchester, MA

All providers in Manchester, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.