Provider Demographics
NPI:1104369602
Name:DEEM, ANGELA WEBB (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:WEBB
Last Name:DEEM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SHERRY MAY ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-6000
Mailing Address - Country:US
Mailing Address - Phone:540-965-1373
Mailing Address - Fax:540-965-1393
Practice Address - Street 1:104 SHERRY MAY ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-6000
Practice Address - Country:US
Practice Address - Phone:540-965-1373
Practice Address - Fax:540-965-1393
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040096831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical