Healthcare Provider Details

I. General information

NPI: 1083761373
Provider Name (Legal Business Name): MARGARET LEE BAGNAL L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 AUBURN RD
AVONDALE PA
19311-9382
US

IV. Provider business mailing address

360 AUBURN RD
AVONDALE PA
19311-9382
US

V. Phone/Fax

Practice location:
  • Phone: 610-324-5254
  • Fax: 775-262-6312
Mailing address:
  • Phone: 610-268-1382
  • Fax: 775-262-6312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04566300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014782
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: