Provider Demographics
NPI:1639500846
Name:ANGELA M. STELIGA, LICSW, CORP
Entity type:Organization
Organization Name:ANGELA M. STELIGA, LICSW, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STELIGA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-523-0515
Mailing Address - Street 1:25 MARKET ST STE 14
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3998
Mailing Address - Country:US
Mailing Address - Phone:401-523-0515
Mailing Address - Fax:508-379-1112
Practice Address - Street 1:25 MARKET ST STE 14
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3998
Practice Address - Country:US
Practice Address - Phone:401-523-0515
Practice Address - Fax:508-379-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1141671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110084555AMedicaid
MAP0551101OtherPTAN