Provider Demographics
NPI:1194163410
Name:WIMMER, ANGELIKA BRIGITTE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELIKA
Middle Name:BRIGITTE
Last Name:WIMMER
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 1:3006 BONSALL LN
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-6199
Mailing Address - Country:US
Mailing Address - Phone:540-427-1260
Mailing Address - Fax:
Practice Address - Street 1:3006 BONSALL LN
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-6199
Practice Address - Country:US
Practice Address - Phone:540-427-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-08
Last Update Date:2013-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040071951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical