Provider Demographics
NPI:1205965720
Name:DEANGELIS, LENORE THOMAS (LCSW)
Entity type:Individual
Prefix:MS
First Name:LENORE
Middle Name:THOMAS
Last Name:DEANGELIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10016 WADING POOL PATH
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2342
Mailing Address - Country:US
Mailing Address - Phone:512-536-0707
Mailing Address - Fax:512-727-8956
Practice Address - Street 1:1008 MOPAC CIRCLE, SUITE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6808
Practice Address - Country:US
Practice Address - Phone:512-536-0707
Practice Address - Fax:512-727-8956
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX163031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical