MEDICARE: MS. TERESA LYNNE D'ARCANGELIS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	094072	NY

General Provider Information

NPI Number	:	1104492719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA LYNNE D'ARCANGELIS LCSW

Provider Business Mailing Address
First Line	:	512 W SAND LAKE RD
Second Line	:
City	:	WYNANTSKILL
State	:	NY
Zip	:	12198-8140
Country	:	US
Telephone Number	:	518-947-8476
Fax Number	:

Provider Business Practice Location Address
First Line	:	512 W SAND LAKE RD
Second Line	:
City	:	WYNANTSKILL
State	:	NY
Zip	:	12198-8140
Country	:	US
Telephone Number	:	518-947-8476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2021
Last Update Date	:	10/17/2024

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