Provider Demographics
NPI:1972133882
Name:SISLER, ANGELA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SISLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:MATHIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:MC HENRY
Mailing Address - State:MD
Mailing Address - Zip Code:21541-0082
Mailing Address - Country:US
Mailing Address - Phone:681-231-3750
Mailing Address - Fax:
Practice Address - Street 1:69 WOLF ACRES DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-2046
Practice Address - Country:US
Practice Address - Phone:301-533-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00944892104100000X
MD220801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker