Agnes Anne Bissett, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

643729 Issued in MI

Practice address

1209 Richardson St
Port Huron, MI 48060-3548

Phone

(810) 984-5156

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Agnes Anne Goulette Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Huron County Community Mental Health Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bad Axe, MI
  • NPI 1659485514
  Medicare reassignment NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220313600000",
    "number": "1972644458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-985-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 RICHARDSON ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603548",
            "telephone_number": "810-984-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSETT",
        "first_name": "AGNES",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "643729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "0M85900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M85900021",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "GOULETTE",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Halah S Billy, PHARMD
• Hollie M Binkley, CLD, CLE, CLSP
• Bio-Medical Applications of Michigan, Inc.
• Helen Birkbeck, APRN
• Jill Anne Biskner, LLMSW
• James Black, MA, BS
• Katherine Ann Blackwell
• Lori Blair
• Sherry Blais, RN
• Tara Lynn Blank, PA-C

• Clinical Social Worker in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.