Provider Demographics
NPI:1124374913
Name:CONTO, ANGELIQUE ALICIA
Entity Type:Individual
Prefix:MS
First Name:ANGELIQUE
Middle Name:ALICIA
Last Name:CONTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-7501
Mailing Address - Country:US
Mailing Address - Phone:617-912-7914
Mailing Address - Fax:
Practice Address - Street 1:201 BROADWAY
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-7501
Practice Address - Country:US
Practice Address - Phone:617-912-7914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health