Provider Demographics
NPI:1114604055
Name:NEWSOME, ANGELICA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 TERRAVIEW CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1868
Mailing Address - Country:US
Mailing Address - Phone:410-707-4556
Mailing Address - Fax:
Practice Address - Street 1:7725 TERRAVIEW CT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1868
Practice Address - Country:US
Practice Address - Phone:410-707-4556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD223721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical