Provider Demographics
NPI:1043996663
Name:RISIUS, ANGELA (LMSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:RISIUS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:PANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:HOHER RAIN 8
Mailing Address - Street 2:
Mailing Address - City:GIESSEN
Mailing Address - State:HESSEN
Mailing Address - Zip Code:35394
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HOHER RAIN 8
Practice Address - Street 2:
Practice Address - City:GIESSEN
Practice Address - State:HESSEN
Practice Address - Zip Code:35394
Practice Address - Country:DE
Practice Address - Phone:321-945-5348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118607104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker