Provider Demographics
NPI:1316799422
Name:DANGELO, ERIN (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DANGELO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:BELLIVEAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8 BATES PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4002
Mailing Address - Country:US
Mailing Address - Phone:781-507-4151
Mailing Address - Fax:
Practice Address - Street 1:8 BATES PARK AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4002
Practice Address - Country:US
Practice Address - Phone:781-507-4151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW227303104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker