Healthcare Provider Details

I. General information

NPI: 1205081254
Provider Name (Legal Business Name): ANGELUS THERAPEUTIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 06/13/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N JEFFERSON ST
NEW CASTLE PA
16101-2238
US

IV. Provider business mailing address

401 N JEFFERSON ST
NEW CASTLE PA
16101-2238
US

V. Phone/Fax

Practice location:
  • Phone: 724-654-9555
  • Fax: 724-498-0976
Mailing address:
  • Phone: 724-654-9555
  • Fax: 724-498-0976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number89319997
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NESSA L SMITH
Title or Position: DIRECTOR
Credential: LCSW MSW MBA
Phone: 724-654-9555