Provider Demographics
NPI:1215620653
Name:HAUPT, ANGELA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:HAUPT
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 1:10949 TREY RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-9663
Mailing Address - Country:US
Mailing Address - Phone:814-386-3003
Mailing Address - Fax:
Practice Address - Street 1:2500 CASSADY AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2674
Practice Address - Country:US
Practice Address - Phone:814-345-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA136988104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker