1821326653 NPI number — BARBARA NAGEL, LCSW

Table of content: (NPI 1821326653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821326653 NPI number — BARBARA NAGEL, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARBARA NAGEL, LCSW
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821326653
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
49 AMHERST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SWARTHMORE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19081-1613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-541-0630
Provider Business Mailing Address Fax Number:
610-541-0630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 N MONROE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEDIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19063-3052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-541-0630
Provider Business Practice Location Address Fax Number:
610-541-0630
Provider Enumeration Date:
12/07/2009

Additional Information

Authorized Official

Authorized Official Last Name:
NAGEL
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
WHITNEY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-541-0630

Provider Taxonomy Codes

  • Taxonomy code: 261QM0855X , with the licence number:  CW012270 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 101008768 0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 276060000 . This is a "MAGELLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2112771000 . This is a "INDEPENDENCE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 398267 . This is a "MHN/TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7968378 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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