Provider Demographics
NPI:1255489365
Name:NAGEL, BARBARA WHITNEY (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:WHITNEY
Last Name:NAGEL
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 1:49 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-1613
Mailing Address - Country:US
Mailing Address - Phone:610-541-0630
Mailing Address - Fax:610-541-0630
Practice Address - Street 1:205 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3052
Practice Address - Country:US
Practice Address - Phone:610-541-0630
Practice Address - Fax:610-541-0630
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0122701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101008768002Medicaid
PA490504OtherVALUE OPTIONS
PA2112771000OtherINDEPENDENCE BLUE CROSS
PA2112771000OtherAMERIHEALTH
PA191874OtherCOMPSYCH
PANA1427381OtherHIGHMARK BLUE SHEILD
PA79688378OtherAETNA
PA79688378OtherAETNA