Angela A Fitch, LCSW
Individual provider Active NPI Clinical Social Worker · Osceola, IN
NPI 1811722697 · NPPES record last updated Sep 3, 2024
Key facts
- NPI
- 1811722697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 34011400A (IN)
- Practice address
- 1415 Lincolnway W Ste Q
Osceola, IN 46561-2063 - Phone
- (574) 651-8912
- NPI assigned
- Sep 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 8, 2024 through Sep 8, 2026
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34011400A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Family Therapy Center Inc | Current |
Accepting new patients | |
| Cornerstone Family Therapy | Past |
Accepting new patients |
Locations
1415 Lincolnway W
Ste Q
Osceola, IN 46561
Phone (574) 651-8912
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34011400A | IN | Yes |
Addresses
Primary practice location
1415 Lincolnway W Ste Q
Osceola, IN 46561-2063
Mailing address
1318 Mossy LN
Mishawaka, IN 46544-9058
Phone (574) 309-3781
Other providers in Osceola, IN
- Jalyn Rose Doyle
- Mary Agnes Dutoi
- Joy Yabut Ealdama
- Kimberly Kathryn Economou
- Blair Endicott
- Frances Dwyer, MD
- Meaghan F Gilroy
- Fred Goldstein
- John Maitland Graham
- Betty Mae Guzman
All providers in Osceola, IN · Clinical Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.