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Provider Information for 1073861746


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ANGELA GUEDES


Sex: Female

NPI: 1073861746
Last Updated: 2024-07-16
Certification Date: 2024-07-16

Details

NameValue
NPI1073861746
Enumeration Date2012-08-28
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 6550 DELILAH ROAD, SUITE 301
ATLANTICARE BEHAVIORAL HEALTH, INC.
EGG HARBOR TOWNSHIP, NJ 08234
United States

Phone: 609-272-8580 | Fax:609-645-7343
 
Primary Practice Address 13 N HARTFORD AVE
ATLANTIC CITY, NJ 08401-3512
United States

Phone: 609-348-1161 | Fax:609-645-7343
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 104100000X - Social Worker NJ44SC05513100
Yes 1041C0700X - Social Worker - ClinicalNJ44SC05513100