Provider Demographics
NPI:1932355948
Name:DEANGELIS, JOSEPH ARTHUR (MA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ARTHUR
Last Name:DEANGELIS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CT
Mailing Address - Zip Code:06377-1522
Mailing Address - Country:US
Mailing Address - Phone:401-439-4925
Mailing Address - Fax:
Practice Address - Street 1:645 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DANIELSON
Practice Address - State:CT
Practice Address - Zip Code:06239-2108
Practice Address - Country:US
Practice Address - Phone:401-439-4925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-09
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1026101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional