Tricia Louise Bragdon, LICSW
Individual provider Active NPI Social Worker · Lee, MA
NPI 1972085363 · NPPES record last updated Aug 31, 2018
Key facts
- NPI
- 1972085363
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 1029723 (MA)
- Practice address
- 650 Stockbridge Rd
Lee, MA 01238-9315 - Phone
- (413) 441-0845
- NPI assigned
- Aug 31, 2018
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1029723 | MA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 1029723 | MA | Yes |
Addresses
Primary practice location
650 Stockbridge Rd
Lee, MA 01238-9315
Mailing address
650 Stockbridge Rd
Lee, MA 01238-9315
Other providers in Lee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2018. 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.