Provider Demographics
NPI:1417907601
Name:DARCANGELO, MICHAEL F (LCSW, LCADC, SAP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:F
Last Name:DARCANGELO
Suffix:
Gender:M
Credentials:LCSW, LCADC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33-11 BROADWAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4634
Mailing Address - Country:US
Mailing Address - Phone:201-796-4540
Mailing Address - Fax:201-475-8251
Practice Address - Street 1:33-11 BROADWAY
Practice Address - Street 2:SUITE 205
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-4634
Practice Address - Country:US
Practice Address - Phone:201-796-4540
Practice Address - Fax:201-475-8251
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00054600101YA0400X
NJ44SC045690001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical