Provider Demographics
NPI:1346415759
Name:KEMMER, ANGELA FAYE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:FAYE
Last Name:KEMMER
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 1:73 HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-2005
Mailing Address - Country:US
Mailing Address - Phone:305-852-2240
Mailing Address - Fax:305-852-6902
Practice Address - Street 1:73 HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2005
Practice Address - Country:US
Practice Address - Phone:305-852-2240
Practice Address - Fax:305-852-6902
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 89721041C0700X
FLSW8972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1346415759Medicare NSC