| Angelina Miceli Lcsw Pllc | |
|
29 Clintonville Rd North Haven CT 06473-2322 | |
| (203) 848-0131 | |
| Not Available |
| Full Name | Angelina Miceli Lcsw Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 29 Clintonville Rd, North Haven, Connecticut |
| Authorized Official Name and Position | Angelina Miceli (OWNER) |
| Authorized Official Contact | 2038480131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angelina Miceli Lcsw Pllc 29 Clintonville Rd North Haven CT 06473-2322 Ph: () - | Angelina Miceli Lcsw Pllc 29 Clintonville Rd North Haven CT 06473-2322 Ph: (203) 848-0131 |
| NPI Number | 1538839717 |
|---|---|
| Provider Enumeration Date | 09/17/2021 |
| Last Update Date | 09/17/2021 |
| Certification Date | 09/11/2021 |
| Medicare PECOS PAC ID | 2668860313 |
|---|---|
| Medicare Enrollment ID | O20211028002565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538839717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Angelina Miceli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871944496 PECOS PAC ID: 8729349493 Enrollment ID: I20180221002330 |
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