Provider Demographics
NPI:1225285786
Name:AGNELL, BARBARA VIRGINIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:VIRGINIA
Last Name:AGNELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7806 UPLANDS WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7567
Mailing Address - Country:US
Mailing Address - Phone:916-967-6253
Mailing Address - Fax:
Practice Address - Street 1:7806 UPLANDS WAY
Practice Address - Street 2:SUITE A
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7567
Practice Address - Country:US
Practice Address - Phone:916-967-6253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15108104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker