Provider Demographics
NPI:1013767102
Name:BAGGETT, DARCY M (LCSW)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:M
Last Name:BAGGETT
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 1:78 OLD PENNELLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-7909
Mailing Address - Country:US
Mailing Address - Phone:207-841-0527
Mailing Address - Fax:
Practice Address - Street 1:78 OLD PENNELLVILLE RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-7909
Practice Address - Country:US
Practice Address - Phone:207-841-0527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC73741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty