Healthcare Provider Details

I. General information

NPI: 1215175096
Provider Name (Legal Business Name): ANGEK LAVERNE MONROE LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2009
Last Update Date: 02/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 KIRK AVE
BALTIMORE MD
21218-4826
US

IV. Provider business mailing address

12 E PRESTON ST APT. 2
BALTIMORE MD
21202-7701
US

V. Phone/Fax

Practice location:
  • Phone: 410-467-6040
  • Fax:
Mailing address:
  • Phone: 240-522-9186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14305
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: