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General NPI Number Information
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NPI Number | 1376772384
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Entity Type | Individual
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Provider Name | ANGELA RAE KOLKMAN WHIDDEN MSW, LISW-S
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Gender | Female
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Dates
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Enumeration Date | 07/11/2009
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 3500 CARNEGIE AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-2641
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Country | US
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Telephone | 216-952-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 17825 BALDWIN PL
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City | LAKEWOOD
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State | OH
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Zip | 44107-1004
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Country | US
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Telephone | 808-269-3487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | S.1000340
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License Number State | OH
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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 | I.1200522
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License Number State | OH
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