Maria Annunziata Fagan, M.ED, LAC, NCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

37AC00710200 Issued in NJ

Practice address

666 Godwin Ave Ste And330
Midland Park, NJ 07432-1449

Phone

(551) 319-2029

NPI assigned

Mar 13, 2023

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Beautiful Journey Counseling

  • Mental Health Counselor
  • Mahwah, NJ
  • NPI 1144866542
  NPD (past)

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1821799487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 WYCKOFF AVE STE AND303",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303186",
            "telephone_number": "551-319-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 GODWIN AVE STE AND330",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321449",
            "telephone_number": "551-319-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "MARIA",
        "middle_name": "ANNUNZIATA",
        "credential": "M.ED, LAC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37AC00710200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.beautifuljc.com/",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "666 Godwin Ave Ste And330",
            "city": "Midland Park",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "074321449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marcia L Egedy, DMD
• R. Hope Eliasof, MSW LCSW
• Elizabeth Voegtlin LCSW LLC
• Kathleen Marie Elleo, LCSW
• Raymond Paul Eskow, M.D.
• Liany Farinas-Han, DMD
• Meridith Farley, M.S., CCC-SLP
• Mary Ellen Fassnacht, LCSW
• Kevin M. Feeley, LCSW
• Alyssa Kay Fitzsimmons, APN

• Marriage & Family Therapist in Midland Park, NJ
• Providers in Midland Park, NJ by specialty
• Marriage & Family Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.