Provider Demographics
NPI:1811238678
Name:ANGELO, DENISE A (LCSW-R)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:ANGELO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-1812
Mailing Address - Country:US
Mailing Address - Phone:845-265-9073
Mailing Address - Fax:
Practice Address - Street 1:22 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516-1812
Practice Address - Country:US
Practice Address - Phone:845-265-9073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0403791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical