Provider Demographics
NPI:1891402665
Name:ARCANGELETTI, MICHAEL (LSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ARCANGELETTI
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:JENKINS TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18640-1333
Mailing Address - Country:US
Mailing Address - Phone:570-301-3565
Mailing Address - Fax:
Practice Address - Street 1:1605 RIVER RD
Practice Address - Street 2:
Practice Address - City:JENKINS TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18640-1333
Practice Address - Country:US
Practice Address - Phone:570-301-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138157104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASW138157OtherDEPARTMENT OF STATE - BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS