Provider Demographics
NPI:1316483290
Name:SANTANGELO, ANNEMARIE (LADC-I, CADAC-II)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:SANTANGELO
Suffix:
Gender:F
Credentials:LADC-I, CADAC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 CENTRAL ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-2107
Mailing Address - Country:US
Mailing Address - Phone:781-231-7420
Mailing Address - Fax:
Practice Address - Street 1:228 CENTRAL ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-2107
Practice Address - Country:US
Practice Address - Phone:781-231-7420
Practice Address - Fax:781-231-1507
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA65101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health