Provider Demographics
NPI:1487221172
Name:REESE, ANGELA (MSW, LSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:REESE
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 1:6718 HUNTERS GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-2827
Mailing Address - Country:US
Mailing Address - Phone:317-507-2119
Mailing Address - Fax:
Practice Address - Street 1:3500 DEPAUW BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1170
Practice Address - Country:US
Practice Address - Phone:317-471-8996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99081725A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical