Provider Demographics
NPI:1639362304
Name:ANGELUS PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:ANGELUS PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:TERESE
Authorized Official - Last Name:GRABOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:724-654-9555
Mailing Address - Street 1:101 E WALLACE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-2438
Mailing Address - Country:US
Mailing Address - Phone:724-654-9555
Mailing Address - Fax:724-654-9555
Practice Address - Street 1:318 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3626
Practice Address - Country:US
Practice Address - Phone:724-654-9555
Practice Address - Fax:724-654-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1354033OtherHIGHMARK