Individual
SUSANNA P ANGELILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
2 REGENCY PLZ STE 20, PROVIDENCE, RI 02903-3152
(401) 837-1285
(401) 942-4375
Mailing address
226 FLINT AVE, CRANSTON, RI 02910-2514
(401) 942-4375
(401) 942-4375
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00312
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32284-1
BLUE CROSS/BLUE SHIELD
—
01
—
414055
BLUE CHIP
—
01
—
600052724
MAGELLAN
—
05
—
SA65487
—
RI
Enumeration date
02/09/2007
Last updated
09/21/2015
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