Provider Demographics
NPI:1689439770
Name:MUNOZ-VELAZQUEZ, ANGEL MANUEL (LMSW)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:MANUEL
Last Name:MUNOZ-VELAZQUEZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-5425
Mailing Address - Country:US
Mailing Address - Phone:860-470-4726
Mailing Address - Fax:203-717-5474
Practice Address - Street 1:41 E MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-5425
Practice Address - Country:US
Practice Address - Phone:860-470-4726
Practice Address - Fax:203-717-5474
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9098104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker