Provider Demographics
NPI:1700914538
Name:KAUFMAN, ANGELA MARGARET (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARGARET
Last Name:KAUFMAN
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 1:970 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5542
Mailing Address - Country:US
Mailing Address - Phone:203-363-0793
Mailing Address - Fax:203-363-0794
Practice Address - Street 1:1011 HIGH RIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1604
Practice Address - Country:US
Practice Address - Phone:203-363-0793
Practice Address - Fax:203-363-0794
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0025971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT140002597CT01OtherANTHEM BCBS PROVIDER ID
CTZS608OtherOXFORD PROVIDER ID
CT061390301-01OtherPACIFICARE PROVIDER ID
CT5335019OtherAETNA PROVIDER ID
CT17014000OtherMAGELLAN PROVIDER ID
CT6227501OtherUNITED PROVIDER ID
CT158568OtherMHN PROVIDER ID
CT7478642OtherEMPIRE PLAN GHI PROV. ID
CT2913061OtherCIGNA PROVIDER ID
CT158568OtherMHN PROVIDER ID