George Fahey, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

102839 Issued in MA

Practice address

128 Utica St
Quincy, MA 02169-3228

Phone

(617) 328-7564

NPI assigned

Dec 20, 2014

Sex

Male

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Interfaith Social Services Inc

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1902074362
  NPD

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

{
    "created_epoch": "1419033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419033600000",
    "number": "1538567714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 UTICA ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021693228",
            "telephone_number": "617-328-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 UTICA ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021693228",
            "telephone_number": "617-328-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "GEORGE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-20",
        "last_updated": "2014-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "102839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ez Care, LLC.
• Kelly Gray Ezickson, LICSW
• Teresa Chao Faber
• Nicole Fachetti
• Facilitated Healing Ctr LLC
• Tara Lynn Fahey
• Hamidreza Fakhri
• Alana Falco, PT, DPT
• Falling Up Therapy Services
• Fallon Emergency Medical Services, Inc.

• Clinical Social Worker in Quincy, MA
• Providers in Quincy, 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 Dec 20, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.