Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Kelly Ann Fagan, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1659516623

Mrs. Kelly Ann Fagan, CCC-SLP is a Speech-Language Pathologist in Greenville, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2008
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

2352 County Route 41
Greenville, NY 12083-4626
Phone: (518) 966-5447
Fax: (518) 966-5447
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 008897 (NY)

Record details

NPI number1659516623
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorYes
NPI enumeratedDecember 4, 2008
Last updated in NPPESDecember 4, 2008

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