Whitney O Agyeman
Individual provider Active NPI Clinical Social Worker · Bristol, CT
NPI 1740016583 · NPPES record last updated Sep 9, 2024
Key facts
- NPI
- 1740016583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 43 Prospect St
Bristol, CT 06010-5071 - Phone
- (860) 584-2105
- NPI assigned
- Sep 9, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
43 Prospect St
Bristol, CT 06010-5071
Mailing address
43 Prospect St
Bristol, CT 06010-5071
Phone (860) 584-2105
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All providers in Bristol, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2024. 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.