Provider Demographics
NPI:1841830833
Name:ANGLADE, JEMIMA (LICSW)
Entity type:Individual
Prefix:
First Name:JEMIMA
Middle Name:
Last Name:ANGLADE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 BELAIR DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2607
Mailing Address - Country:US
Mailing Address - Phone:407-394-4449
Mailing Address - Fax:
Practice Address - Street 1:1500 FRANKLIN ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2000
Practice Address - Country:US
Practice Address - Phone:202-745-3012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical