Provider Demographics
NPI:1912188616
Name:ANGLIN, LAMOUNT (MASTERS DEGREE)
Entity Type:Individual
Prefix:MR
First Name:LAMOUNT
Middle Name:
Last Name:ANGLIN
Suffix:
Gender:M
Credentials:MASTERS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 WEAVER ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1321
Mailing Address - Country:US
Mailing Address - Phone:845-457-9843
Mailing Address - Fax:845-457-9843
Practice Address - Street 1:68 WEAVER ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1321
Practice Address - Country:US
Practice Address - Phone:845-457-9843
Practice Address - Fax:845-457-9843
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003385101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health