Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Courtney Lynne Fagan, MSCCC-SLP, QOM

Individual provider Speech-Language Pathologist · NPI 1184183642

Courtney Lynne Fagan, MSCCC-SLP, QOM is a Speech-Language Pathologist in Clearwater, Florida. Practices as a sole proprietor and works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2019
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Practice location Address checks out

1700 N McMullen Booth Rd Ste D4
Clearwater, FL 33759-2129
Phone: (727) 458-3902
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6323 Memorial Hwy, Tampa, FL 33615-4509 — (727) 458-3902

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 21174 (FL)

Record details

NPI number1184183642
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP , QOM
Sole proprietorYes
NPI enumeratedMarch 14, 2019
Last updated in NPPESAugust 19, 2024
Certification dateAugust 19, 2024

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