Provider Demographics
NPI:1912030545
Name:O'HAGAN, ANGIE MARIA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGIE
Middle Name:MARIA
Last Name:O'HAGAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 N LADOW AVE
Mailing Address - Street 2:18G
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-1475
Mailing Address - Country:US
Mailing Address - Phone:856-558-0686
Mailing Address - Fax:
Practice Address - Street 1:128 CREST HAVEN RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1651
Practice Address - Country:US
Practice Address - Phone:609-465-4100
Practice Address - Fax:609-465-2566
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054247001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ185219Medicare Oscar/Certification