Provider Demographics
NPI:1083776603
Name:ANGAROLA, DEBRA GRACE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:GRACE
Last Name:ANGAROLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:325 BROOKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-4335
Mailing Address - Country:US
Mailing Address - Phone:706-207-7519
Mailing Address - Fax:706-510-2619
Practice Address - Street 1:1353 JENNINGS MILL RD
Practice Address - Street 2:SUITE D, BOX11
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7290
Practice Address - Country:US
Practice Address - Phone:706-207-7519
Practice Address - Fax:706-510-2619
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0033591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical