Healthcare Provider Details

I. General information

NPI: 1003612748
Provider Name (Legal Business Name): ANGELICA MARIE ALBEK BSN-RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. ANGELICA FOTI

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E STATE ST STE D
ATHENS OH
45701-1870
US

IV. Provider business mailing address

3151 ADAMS RD
KINGSVILLE OH
44048-7752
US

V. Phone/Fax

Practice location:
  • Phone: 740-212-1391
  • Fax:
Mailing address:
  • Phone: 440-346-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberOH-RN475283
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberOH-RN475283
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberOH-RN475283
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: