Healthcare Provider Details

I. General information

NPI: 1487574992
Provider Name (Legal Business Name): ANGELICA CANALES LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 CLINTON AVE
NEWARK NJ
07114-2012
US

IV. Provider business mailing address

316 26TH ST
UNION CITY NJ
07087-4560
US

V. Phone/Fax

Practice location:
  • Phone: 973-482-8312
  • Fax:
Mailing address:
  • Phone: 201-449-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07501300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: