Joana Abena Fagbola, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

012692 Issued in CT

Practice address

2527 Glebe Ave
Bronx, NY 10461-3109

Phone

(718) 904-4400

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Joana Abena Fitti Former name

Medicare fee-for-service enrollment

Enrolled in CT

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.

Enrollment records 1

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.

• Mellahealth LLC

  • Community/Behavioral Health Agency
  • West Hartford, CT
  • NPI 1477158046

  Clinical

  Medicare reassignment NPD
• Ruby Psychiatric Services, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Hartford, CT
  • NPI 1295564425
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1962996371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SOUTH ST APT 1",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012500",
            "telephone_number": "347-712-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2527 GLEBE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613109",
            "telephone_number": "718-904-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "064603413",
            "country_code": "US",
            "telephone_number": "347-712-9719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAGBOLA",
        "first_name": "JOANA",
        "middle_name": "ABENA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "092894-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093759-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "012692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONTEFIORE MEDICAL CENTER",
            "identifier": "1952-476-988",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANA",
            "last_name": "FITTI",
            "middle_name": "ABENA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brownie Fagan, RN BSN CMSRN
• David Fagan, M.D.
• Michele J Fagan, MD
• Lanrewaju Fagbenro
• Clara Fagbeyiro, RN
• Adina Fagin, MD
• Dennis Fagundo-Ojeda, PHD
• Anam Fahad, MD
• Youmna Faheem
• Kathleen M. Fahey, R.N.

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, 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 Feb 7, 2023; 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.