Provider Demographics
NPI:1871686634
Name:BAKER, ANGELIA MICHELLE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELIA
Middle Name:MICHELLE
Last Name:BAKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:ANGELIA
Other - Middle Name:MICHELLE
Other - Last Name:BAKER-MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:8923 HEATHERMORE BLVD #301
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772
Mailing Address - Country:US
Mailing Address - Phone:240-917-7093
Mailing Address - Fax:
Practice Address - Street 1:120 R ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2120
Practice Address - Country:US
Practice Address - Phone:202-526-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500779781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical