Provider Demographics
NPI:1437288032
Name:PRECHT, ANGELA C (LISW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:C
Last Name:PRECHT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:C
Other - Last Name:DRENNEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:DEPT 781625
Mailing Address - Street 2:P.O. BOX 78000
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1625
Mailing Address - Country:US
Mailing Address - Phone:614-355-8004
Mailing Address - Fax:614-355-2220
Practice Address - Street 1:275 W SCHROCK RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2874
Practice Address - Country:US
Practice Address - Phone:614-355-8230
Practice Address - Fax:614-355-8231
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI102961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846675Medicaid