Provider Demographics
NPI:1770067274
Name:ORDYNIEC, ANGELA VIRGINIA (MSSW, LISW-CP, LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:VIRGINIA
Last Name:ORDYNIEC
Suffix:
Gender:F
Credentials:MSSW, LISW-CP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 STUART ENGALS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7312
Mailing Address - Country:US
Mailing Address - Phone:843-459-9805
Mailing Address - Fax:
Practice Address - Street 1:1435 STUART ENGALS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7312
Practice Address - Country:US
Practice Address - Phone:843-459-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0860171041C0700X
CA1087251041C0700X
MN299511041C0700X
NJ44SC060955001041C0700X
SC149241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical