Michelle Marie Fagnano, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106332 Issued in MA

Practice address

585 Lincoln Street
Worcester, MA 01605

Phone

(617) 512-2198

NPI assigned

Mar 14, 2016

Last updated

Sep 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538265600000",
    "number": "1528429818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 JOHN MAHAR HWY",
            "address_2": "UNIT 209",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021846576",
            "telephone_number": "617-587-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LINCOLN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "617-512-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGNANO",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2018-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Jane Faber, PMHNP-BC
• Cassandra Facchiano
• Eleanore Faenza, NP
• Kayla Lynn Fafard, LICSW
• Kathleen Bennett Faggella-Luby
• Alexander L Fagundes
• Linda A Fagundes, PA-C
• Julianne Fahey
• Kelsey Fahey
• Michael C. Fahey, M.D.

• Clinical Social Worker in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2018; 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.