Provider Demographics
NPI:1992214688
Name:GERMAN, ANGELA (PHD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:NICHOLD
Other - Last Name:HOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7480 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5924
Mailing Address - Country:US
Mailing Address - Phone:754-308-4818
Mailing Address - Fax:
Practice Address - Street 1:7800 W OAKLAND PARK BLVD STE 115
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-1122
Practice Address - Country:US
Practice Address - Phone:954-900-2948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3424101YA0400X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14095227OtherCAQH PROVIDER
FL101521100Medicaid