Jeslyn Elizabeth Agee, LLBSW
Individual provider Active NPI Social Worker · Cadillac, MI
NPI 1386010205 · NPPES record last updated Oct 19, 2015
Key facts
- NPI
- 1386010205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802088105 (MI)
- Practice address
- 527 Cobb St
Cadillac, MI 49601-2540 - Phone
- (231) 775-3463
- Fax
- (231) 775-1692
- NPI assigned
- Aug 14, 2015
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 6802088105 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802088105 | MI | Yes |
Addresses
Primary practice location
527 Cobb St
Cadillac, MI 49601-2540
Mailing address
1223 Barlow St
Traverse City, MI 49686-4256
Phone (517) 612-4045
Other providers in Cadillac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.