Provider Demographics
NPI:1932254232
Name:VANGELI, MARGARET JANE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:JANE
Last Name:VANGELI
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 1:12 HEMLOCK PARK DR
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1450
Mailing Address - Country:US
Mailing Address - Phone:978-448-2872
Mailing Address - Fax:978-449-0182
Practice Address - Street 1:12 HEMLOCK PARK DR
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1450
Practice Address - Country:US
Practice Address - Phone:978-448-2872
Practice Address - Fax:978-449-0182
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1021521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22197Medicare ID - Type Unspecified