Provider Demographics
NPI:1073747531
Name:DAY, ANGELA PATRICE (LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:PATRICE
Last Name:DAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 STAPLETON LN
Mailing Address - Street 2:
Mailing Address - City:SUBIACO
Mailing Address - State:AR
Mailing Address - Zip Code:72865-9187
Mailing Address - Country:US
Mailing Address - Phone:907-715-4523
Mailing Address - Fax:
Practice Address - Street 1:120 STAPLETON LN
Practice Address - Street 2:
Practice Address - City:SUBIACO
Practice Address - State:AR
Practice Address - Zip Code:72865-9187
Practice Address - Country:US
Practice Address - Phone:907-715-4523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR22416-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty