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Contact Information

JACQUELINE BANGO, LICSW
55 FRUIT STREET
FOUNDERS BUILDING SUITE 880
BOSTON, MA02114
 Phone: 617-643-8281
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for JACQUELINE BANGO · (Female)

NPI # 1003329095
Status Active
Credentials LICSW (Licensed Independent Clinical Social Worker)
Entity Individual
Enumeration date 11/13/2017
Last updated 11/13/2017 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • MA License # 120046
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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