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General NPI Number Information
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NPI Number | 1003852286
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Entity Type | Organization
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Legal Business Name | ANGEL FOUNDATION
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 100 W 22ND ST
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City | BALTIMORE
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State | MD
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Zip | 21218-5602
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Country | US
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Telephone | 410-467-0507
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Fax | 410-467-2413
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Provider Business Mailing Address
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Address Line | 100 W 22ND ST
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City | BALTIMORE
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State | MD
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Zip | 21218-5602
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Country | US
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Telephone | 410-467-0507
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Fax | 410-467-2413
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. SHARON F. BROY
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Credential | LCSW-C, BCD
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Telephone | 410-467-0507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 09114
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 04058
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC0380
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License Number State | MD
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