Provider Demographics
NPI:1700468717
Name:AGBAR, JESSICA CHIAMAKA (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:CHIAMAKA
Last Name:AGBAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9208 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3214
Mailing Address - Country:US
Mailing Address - Phone:202-758-6982
Mailing Address - Fax:
Practice Address - Street 1:4311 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-1937
Practice Address - Country:US
Practice Address - Phone:301-882-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26990104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker