MEDICARE: CAITLIN AGNETA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW18232	SC

General Provider Information

NPI Number	:	1730732371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN AGNETA

Provider Business Mailing Address
First Line	:	3520 W MONTAGUE AVE STE 201
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-6099
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3520 W MONTAGUE AVE STE 201
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-6099
Country	:	US
Telephone Number	:	843-793-2104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2019
Last Update Date	:	11/14/2025

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Directions to “ CAITLIN AGNETA ” Practice Location

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