Active NPI
Anthonyesha Fagan
- Mental Health Counselor
- Toledo, OH
National Provider Identifier
1831514371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 821 Southbriar Rd
Toledo, OH 43607-2561 - Phone
- (419) 279-3433
- NPI assigned
- Feb 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Contractor | 171W00000X | 4807696 | OH | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
821 Southbriar Rd
Toledo, OH 43607-2561
Mailing address
821 Southbriar Rd
Toledo, OH 43607-2561
Phone (419) 705-9168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4807696 | OH | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skyfall Residential Homes | Current | Accepting new patients | |
| Skyfall Residential Homes | Current | Accepting new patients | |
| Helping US Grow Socially | Current | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Toledo, OH
- NPI 1255804894
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Toledo, OH
- NPI 1780259663
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Toledo, OH
- NPI 1962077842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748908800000",
"number": "1831514371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "821 SOUTHBRIAR RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436072561",
"telephone_number": "419-705-9168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 SOUTHBRIAR RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436072561",
"telephone_number": "419-279-3433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "ANTHONYESHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-20",
"last_updated": "2025-06-03",
"certification_date": "2025-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "4807696",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.