Provider Demographics
NPI:1285071316
Name:ANGELA RITA-FARIAS LCSW PLLC
Entity type:Organization
Organization Name:ANGELA RITA-FARIAS LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RITA-FARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LP
Authorized Official - Phone:914-930-8922
Mailing Address - Street 1:104 S DIVISION ST
Mailing Address - Street 2:2B
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-3610
Mailing Address - Country:US
Mailing Address - Phone:914-930-8922
Mailing Address - Fax:914-930-8933
Practice Address - Street 1:104 S DIVISION ST
Practice Address - Street 2:2B
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-3610
Practice Address - Country:US
Practice Address - Phone:914-930-8922
Practice Address - Fax:914-930-8933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0709781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty