Susan G. Fago, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC50078121 Issued in DC

Practice address

1555 Connecticut Ave NW Ste 401
Washington, DC 20036-1124

Phone

(202) 441-7240

NPI assigned

Mar 8, 2007

Last updated

Jul 9, 2007By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881725455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1882 COLUMBIA RD NW APT 202",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200095137",
            "telephone_number": "202-483-8148",
            "fax_number": "301-927-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 CONNECTICUT AVE NW STE 401",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361124",
            "telephone_number": "202-441-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGO",
        "first_name": "SUSAN",
        "middle_name": "G.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078121",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omowunmi Abiola Fagbuyi
• Pauline Fagbuyi
• Douglas Brian Fagen, PHD
• Alec Faggen, MD
• Walter Lee Faggett II, M.D.
• Melissa Teresa Fagonde, MD
• Elizabeth Fagunwa
• Kelly Elizabeth Fahey
• Natasha Nina Fahim
• Sahar Fahimi

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.