Provider Demographics
NPI:1801975057
Name:D'ANGELO, FRED W II (LMHC)
Entity type:Individual
Prefix:MR
First Name:FRED
Middle Name:W
Last Name:D'ANGELO
Suffix:II
Gender:M
Credentials:LMHC
Other - Prefix:
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Mailing Address - Street 1:111 ELM ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1967
Mailing Address - Country:US
Mailing Address - Phone:508-756-3750
Mailing Address - Fax:508-756-2729
Practice Address - Street 1:111 ELM ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1967
Practice Address - Country:US
Practice Address - Phone:508-756-3750
Practice Address - Fax:508-756-2729
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA82101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health