Provider Demographics
NPI:1700336021
Name:NORTEY, ANGELINA (PHD)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:NORTEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 COLUMBIA PIKE APT 106
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-3188
Mailing Address - Country:US
Mailing Address - Phone:845-270-1178
Mailing Address - Fax:
Practice Address - Street 1:709 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314
Practice Address - Country:US
Practice Address - Phone:703-664-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1001203103T00000X
MD5767103T00000X
47474103TS0200X
VA0810006273103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool