MEDICARE: ANGELA SIM-LARAMEE MSW, LCSW

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	1041C0700X	Clinical Social Worker	CW020353	PA

General Provider Information

NPI Number	:	1881197473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA SIM-LARAMEE MSW, LCSW

Provider Business Mailing Address
First Line	:	1228 S 48TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-3846
Country	:	US
Telephone Number	:	267-257-1020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1904 SOUTH ST FL 3
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-1434
Country	:	US
Telephone Number	:	484-452-3769
Fax Number	:

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

Provider Enumeration Date	:	03/09/2018
Last Update Date	:	06/16/2021

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