Bannet Agesa, BA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC018904 Issued in PA

Practice address

139 Leopard Rd
Berwyn, PA 19312-1809

Phone

(215) 839-8769

NPI assigned

Jun 21, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1164091641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 W BRIDGE ST # B5",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604342",
            "telephone_number": "104-159-3016",
            "fax_number": "610-415-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 LEOPARD RD",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121809",
            "telephone_number": "215-839-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGESA",
        "first_name": "BANNET",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC018904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Health Information",
            "address_1": "1041 W Bridge St # B5",
            "city": "Phoenixville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194604342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Berwyn, PA
• Providers in Berwyn, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.