Miracle Deysia Fan, MSW, LCSW
NPI 1144943416ActiveIndividual· Social Worker, Clinical· Spring, TX
Social Worker, Clinical (MSW, LCSW) with Legacy Community Health Services, Inc, practicing in Spring, Texas. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1144943416 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MSW, LCSW |
| Sole proprietor | No |
| NPI issued | Sep 22, 2022 |
| Last updated in NPPES | Aug 18, 2026 |
| Certified by provider | Aug 18, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 107417 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (TX) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Legacy Community Health Services, IncHouston, TX · 155 clinicians
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