Provider Demographics
NPI:1922359983
Name:AGNE, AARON (LCSW)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:AGNE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 VANDERBILT ST APT 5O
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-7205
Mailing Address - Country:US
Mailing Address - Phone:646-761-5540
Mailing Address - Fax:
Practice Address - Street 1:24 E 12TH ST RM 604
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4552
Practice Address - Country:US
Practice Address - Phone:646-926-7416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-30
Last Update Date:2012-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0798451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical