Provider Demographics
NPI:1306853379
Name:EMERY, ANGELA K (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:K
Last Name:EMERY
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:PO BOX 419
Mailing Address - Street 2:210 W 4TH STREET
Mailing Address - City:HERMITAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71647-0419
Mailing Address - Country:US
Mailing Address - Phone:870-463-2854
Mailing Address - Fax:
Practice Address - Street 1:210 W 4TH STREET
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:AR
Practice Address - Zip Code:71647-0419
Practice Address - Country:US
Practice Address - Phone:870-463-2854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1737M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker