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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MIRACLE DEYSIA FAN MSW, LCSW
NPI 1144943416
Social Worker - Clinical in Spring, TX

Active since September 22, 2022PECOS Enrolled
26202 OAK RIDGE DR BLDG B204, SPRING, TX 77380(346) 236-1123 Get Directions Write a Review

NPPES record last updated: August 18, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 18, 2026, Jan 9, 2025, Dec 8, 2022 and 1 more (4 updates tracked since 2022).

About Miracle Deysia Fan Msw, Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRACLE DEYSIA FAN MSW, LCSW (NPI 1144943416) is an individual clinical provider in Spring, Texas, licensed in Texas (107417) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Spring, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1144943416
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMIRACLE DEYSIA FANCredential: MSW, LCSW
Location Address26202 OAK RIDGE DR BLDG B204Spring, TX 77380-1994
Mailing Address26202 Oak Ridge Dr Bldg B204Spring, TX 77380-1994
Phone(346) 236-1123
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateSeptember 22, 2022
Last NPPES UpdateAugust 18, 20264 updates tracked since enumeration
NPPES CertifiedAugust 18, 2026
✔ NPI 1144943416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in TX · 107417
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
26202 OAK RIDGE DR BLDG B204, Spring, TX 77380
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Other Names 1

Former Name (1)Miracle Betancourt

Secondary Practice Location 1

Location 11201 Lake Woodlands Dr Ste 4009Spring, TX 77380-5000 · Phone (855) 284-7483 · Fax (617) 807-0958

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miracle Deysia Fan Msw, Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7315440831
PECOS Enrollment IDI20250911001858
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77380 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.84 – $166.88
Typical copayment $0.00 (range $13.71 – $41.72)
Most-billed visit code NA
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Miracle Fan's NPI number?

The NPI number for Miracle Fan is 1144943416. It was assigned to this individual provider in the NPPES registry on September 22, 2022. The provider is also known as Miracle Betancourt.

Where is Miracle Fan located?

Miracle Fan practices at 26202 Oak Ridge Dr Bldg B204, Spring, TX 77380. The listed phone number is (346) 236-1123.

What is Miracle Fan's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Miracle Fan enrolled in Medicare?

Yes. Miracle Fan is registered in the Medicare PECOS enrollment system.

What insurance does Miracle Fan accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Miracle Fan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Miracle Fan was last updated on August 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.