Angela Renee Devault, MSW, CMHT

Individual provider Active NPI Clinical Social Worker · Hernando, MS

NPI 1750006698 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1750006698
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
W9569 (MS)
Practice address
2725 Highway 51 S
Hernando, MS 38632-2634
Phone
(662) 449-1971
NPI assigned
Oct 4, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
W9569MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Region IV Mental Health Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X W9569 MS Yes

Addresses

Primary practice location

2725 Highway 51 S
Hernando, MS 38632-2634

Mailing address

2725 Highway 51 S
Hernando, MS 38632-2634
Phone (662) 449-1971

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address angela.devault@regionivmhs.com Direct

Other providers in Hernando, MS

All providers in Hernando, MS · Clinical Social Worker in Mississippi

Sources for this page

Verify at the official NPI Registry.