Jenna L Bagnini, LMSW

Individual provider Active NPI Social Worker · Mount Kisco, NY

NPI 1104416809 · NPPES record last updated Jan 26, 2021

Key facts

NPI
1104416809
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
108810-01 (NY)
Practice address
25 Pineview Rd
Mount Kisco, NY 10549-3935
Phone
(917) 683-9194
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
108810-01NYMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 108810-01 NY Yes

Addresses

Primary practice location

25 Pineview Rd
Mount Kisco, NY 10549-3935

Mailing address

25 Pineview Rd
Mount Kisco, NY 10549-3935
Phone (917) 683-9194

Other identifiers

IdentifierTypeStateIssuer
108810-01OtherNYREGISTRATION CERTIFICATE

Other providers in Mount Kisco, NY

All providers in Mount Kisco, NY · Social Worker in New York

Sources for this page

Verify at the official NPI Registry.