MEDICARE: ANGELINA PHILPOT LCSW, CADC, NCSSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	420458	KY
2	1041S0200X	School Social Worker	34	KY
3	1041C0700X	Clinical Social Worker	LCSW00001392	KY

General Provider Information

NPI Number	:	1609707140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELINA PHILPOT LCSW, CADC, NCSSW

Provider Business Mailing Address
First Line	:	30 JAXSONS CV
Second Line	:
City	:	SOMERSET
State	:	KY
Zip	:	42503-5488
Country	:	US
Telephone Number	:	606-678-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 JAXSONS CV
Second Line	:
City	:	SOMERSET
State	:	KY
Zip	:	42503-5488
Country	:	US
Telephone Number	:	606-678-8600
Fax Number	:

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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