Mia Teresa D'Agostino, LCSW
Social Worker, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1669953683
StatusActive
Last updated in NPPESAug 27, 2018
Details
- NPI
- 1669953683
- Entity type
- Individual (NPI-1)
- Name
- Mia Teresa D'Agostino
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 27, 2018
- Last updated
- Aug 27, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149-017535 | IL | Yes |
Practice location
2500 W Bradley Pl Ste 210Chicago, IL 60618-4716
Phone 475-215-1234
Mailing address
1526 W Belle Plaine Ave Apt 2Chicago, IL 60613-1857
Phone 773-266-8984
Other practice locations
2500 W Bradley Pl Ste 100
Chicago, IL 60618-4716
Chicago, IL 60618-4716
Phone 475-215-1234
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