Healthcare Provider Details

I. General information

NPI: 1437626447
Provider Name (Legal Business Name): ANGELA A HONAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 3RD ST SE
HEATH OH
43056-9660
US

IV. Provider business mailing address

52 3RD ST SE
HEATH OH
43056-9660
US

V. Phone/Fax

Practice location:
  • Phone: 220-215-7136
  • Fax:
Mailing address:
  • Phone: 220-215-7136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2506589-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: