Healthcare Provider Details

I. General information

NPI: 1689119182
Provider Name (Legal Business Name): ANGELA WESTHEAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA MOSER

II. Dates (important events)

Enumeration Date: 12/20/2016
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 MERCER AVE
FARRELL PA
16121-2505
US

IV. Provider business mailing address

378 WOODBINE AVE SE
WARREN OH
44483-6047
US

V. Phone/Fax

Practice location:
  • Phone: 724-981-9815
  • Fax: 724-981-2293
Mailing address:
  • Phone: 330-518-7068
  • Fax: 247-981-2293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1601928
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: