Jessica Marie Angelo
Individual provider Active NPI Clinical Social Worker · Mooresville, NC
NPI 1659849271 · NPPES record last updated Mar 10, 2022
Key facts
- NPI
- 1659849271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- P017029 (NC)
- Practice address
- 134 Infield CT
Mooresville, NC 28117-8026 - Phone
- (704) 799-6824
- Fax
- (704) 799-6825
- NPI assigned
- Nov 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P017029 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lolly Therapeutics, LLC | Clinical | Past |
Accepting new patients |
| Integrative Therapy Concepts | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Clinical Social Worker | 1041C0700X | P017029 | NC | Yes |
Addresses
Primary practice location
134 Infield CT
Mooresville, NC 28117-8026
Mailing address
134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824
Other practice location 1
16415 Northcross Dr Ste F
Huntersville, NC 28078-5001
Phone (704) 799-6824
Other providers in Mooresville, NC
- Sharda Chenelle Anderson
- Travis Lee Anderson
- Diana Andrade
- Constance A Andrews
- Liliah Andrews
- Angels of Love Respite Home Care
- Anna T. Lukic, DDS, Ms, PA
- Craig Lincoln Anthony
- Matthew J Antonelli
- Lisa S Anzalone
All providers in Mooresville, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.