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

Siedah Fagan

Individual provider Clinical Social Worker · NPI 1013509033

Siedah Fagan is a Clinical Social Worker in Boston, Massachusetts. Qualified in 2019, 7 years ago. Licensed in Massachusetts.

Years since qualifying
7
Licensed in
MA
In the registry since
2021
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Practice location Address checks out

100 Cambridge St Ste 1400
Boston, MA 02114-2545
Phone: (617) 932-3813
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 000226516 (MA)

Record details

NPI number1013509033
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 10, 2021
Last updated in NPPESFebruary 10, 2021
Certification dateJanuary 23, 2021

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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