Individual
MRS. ROBERTA ANN NAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LADAC1
Contact information
Practice address
585 LINCOLN STREET, WORCESTER, MA 01605
(508) 854-3320
(508) 753-5051
Mailing address
585 LINCOLN STREET, WORCESTER, MA 01605
(508) 854-3320
(508) 753-5051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
204233
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306421
—
MA
01
—
1308785
BCBS MH M18684
MA
01
—
2220002001
BCBS SUBSTANCE ABUSE
MA
Enumeration date
10/16/2006
Last updated
07/08/2007
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