Arwen S. Agee, LCSW

Key facts

NPI

1508020173

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

LC12715 (ME)

Practice address

1 VA Ctr
116A
Augusta, ME 04330-6719

Phone

(207) 623-8411

NPI assigned

Jul 14, 2008

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)

Yes

Specialties & licenses

Addresses

Other names

• Arwen Roth Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 24, 2015.

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1508020173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VA CTR",
            "address_2": "116A",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VA CTR",
            "address_2": "116A",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306719",
            "telephone_number": "207-623-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGEE",
        "first_name": "ARWEN",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARWEN",
            "last_name": "ROTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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