Provider Demographics
NPI:1629432232
Name:KATHRYN ELIZABETH ANGELL PHD
Entity Type:Organization
Organization Name:KATHRYN ELIZABETH ANGELL PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ANGELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:267-368-2678
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-0145
Mailing Address - Country:US
Mailing Address - Phone:267-368-2678
Mailing Address - Fax:
Practice Address - Street 1:349 LANCASTER AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1500
Practice Address - Country:US
Practice Address - Phone:267-368-2678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-09
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017396103TB0200X, 103TC0700X, 103TF0000X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty