Provider Demographics
NPI:1225526866
Name:HACKNEY, ANGELA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HACKNEY
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4852
Mailing Address - Country:US
Mailing Address - Phone:614-946-4265
Mailing Address - Fax:
Practice Address - Street 1:90 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1659
Practice Address - Country:US
Practice Address - Phone:614-783-6010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17003921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical