Provider Demographics
NPI:1821326653
Name:BARBARA NAGEL, LCSW
Entity Type:Organization
Organization Name:BARBARA NAGEL, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:WHITNEY
Authorized Official - Last Name:NAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:610-541-0630
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW012270261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101008768 0001Medicaid
PA276060000OtherMAGELLAN
2112771000OtherINDEPENDENCE BLUE CROSS
398267OtherMHN/TRICARE
PA7968378OtherAETNA
PA101008768 0001Medicaid