MEDICARE: ANGELA KRISTEN DUNKLE LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	S.2512630	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184316598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA KRISTEN DUNKLE LSW

Provider Business Mailing Address
First Line	:	401 EAST MARKET ST.
Second Line	:
City	:	CELINA
State	:	OH
Zip	:	45822-1736
Country	:	US
Telephone Number	:	419-305-7214
Fax Number	:	567-890-7214

Provider Business Practice Location Address
First Line	:	661 NORTH COUNTY ROAD 25A
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-1353
Country	:	US
Telephone Number	:	419-584-5123
Fax Number	:	567-890-7214

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2023
Last Update Date	:	01/29/2026

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