Provider Demographics
NPI:1992876015
Name:ANGEL, VALERIE TATE (MSW)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:TATE
Last Name:ANGEL
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 1:522 W END AVE
Mailing Address - Street 2:APT. 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3228
Mailing Address - Country:US
Mailing Address - Phone:212-874-7631
Mailing Address - Fax:212-874-7061
Practice Address - Street 1:115 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8183
Practice Address - Country:US
Practice Address - Phone:212-751-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO12444-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7404905OtherGHI INSURANCE
NY7324659OtherGHIBMP INSURANCE
NY7324659OtherGHIBMP INSURANCE