Provider Demographics
NPI:1306427075
Name:ANNA AGELL LCSW LLC
Entity type:Organization
Organization Name:ANNA AGELL LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AGELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-522-1831
Mailing Address - Street 1:2 POLLARD AVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-3115
Mailing Address - Country:US
Mailing Address - Phone:207-522-1831
Mailing Address - Fax:207-373-1833
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1221
Practice Address - Country:US
Practice Address - Phone:207-522-1831
Practice Address - Fax:207-373-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)