Provider Demographics
NPI:1669749362
Name:JACANGELO, PIA (MSW)
Entity type:Individual
Prefix:MRS
First Name:PIA
Middle Name:
Last Name:JACANGELO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 HUFF TER
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1703
Mailing Address - Country:US
Mailing Address - Phone:917-921-6948
Mailing Address - Fax:
Practice Address - Street 1:92 HUFF TER
Practice Address - Street 2:
Practice Address - City:UPPER SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-1703
Practice Address - Country:US
Practice Address - Phone:917-921-6948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJN.J. S.C. 009831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical