Provider Demographics
NPI:1982438149
Name:POWELL, ANGELICA (MSW)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1096
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-5096
Mailing Address - Country:US
Mailing Address - Phone:317-363-2698
Mailing Address - Fax:
Practice Address - Street 1:1580 COLD SPRING DR
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2165
Practice Address - Country:US
Practice Address - Phone:317-363-2698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator