Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Chartyise Fagan, MA, LPC

Individual provider Professional Counselor · NPI 1114702081

Chartyise Fagan, MA, LPC is a Mental Health Counselor in Toledo, Ohio. Qualified in 2023, 3 years ago. Accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
3
Licensed in
OH
In the registry since
2023
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

5726 Southwyck Blvd
Toledo, OH 43614-1559
Phone: (419) 705-8597
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence E.2606106 (OH)

Record details

NPI number1114702081
Entity typeIndividual (Type 1)
GenderMale
Credentials MA , LPC
Sole proprietorNo
NPI enumeratedAugust 29, 2023
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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