Provider Demographics
NPI:1528795051
Name:CANGELOSI, MIRELA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MIRELA
Middle Name:
Last Name:CANGELOSI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MIRELA
Other - Middle Name:
Other - Last Name:SERIFOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:430 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-1731
Mailing Address - Country:US
Mailing Address - Phone:540-836-7850
Mailing Address - Fax:
Practice Address - Street 1:1215 N AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-3203
Practice Address - Country:US
Practice Address - Phone:540-885-8841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040142331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical