Individual provider Active NPI

Michelle Agostini, MSW, LSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1487985990
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW127610 Issued in PA
Practice address
21 S 12TH St
Philadelphia, PA 19107-3614
Phone
(215) 732-2437
NPI assigned
Jan 22, 2010
Last updated
Jan 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

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

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

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW127610PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1487985990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 S 49TH ST",
            "address_2": "1R",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191433401",
            "telephone_number": "267-471-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 S 12TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073614",
            "telephone_number": "215-732-2437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINI",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW127610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.