Michael Brian Fagan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

052154 Issued in NY

Practice address

135 Eastern Pkwy Apt 1B
Brooklyn, NY 11238-6037

Phone

(718) 399-7850

NPI assigned

Nov 18, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1699003392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 EASTERN PKWY APT 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112386037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EASTERN PKWY APT 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112386037",
            "telephone_number": "718-399-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-18",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R052154-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "052154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Fafalak, DMD
• Katherine Ann Fafian, OTR
• Alyssa M Fagan, OTR/L
• Carol Fagan
• Kelly Fagan, PA
• Mitchell Ernest Fagan, M.A. SLP-CCC
• Nicola Fagan
• Velma Fagan, R.N.
• Yury Fagans, RN
• Adil Alaho Fagbemi

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.