Michelle Agostini, MSW, LSW

Individual provider Active NPI Clinical Social Worker · Philadelphia, PA

NPI 1487985990 · NPPES record last updated Jan 22, 2010

Key facts

NPI
1487985990
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SW127610 (PA)
Practice address
21 S 12TH St
Philadelphia, PA 19107-3614
Phone
(215) 732-2437
NPI assigned
Jan 22, 2010
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
SW127610PAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW127610 PA Yes

Addresses

Primary practice location

21 S 12TH St
Philadelphia, PA 19107-3614

Mailing address

813 S 49TH St
1R
Philadelphia, PA 19143-3401
Phone (267) 471-6861

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Clinical Social Worker in Pennsylvania

Sources for this page

Verify at the official NPI Registry.