1538785944 NPI number — ANGELA PRIOR LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538785944 NPI number — ANGELA PRIOR LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRIOR
Provider First Name:
ANGELA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PARK
Provider Other First Name:
ANGELA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538785944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 400 PO BOX 6027
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
CAMP HUMPHREYS
Provider Business Mailing Address Postal Code:
96273
Provider Business Mailing Address Country Code:
KR
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL
Provider Second Line Business Practice Location Address:
BLDG 3030 INDIANHEAD AVE
Provider Business Practice Location Address City Name:
USAG HUMPHREYS
Provider Business Practice Location Address State Name:
SOUTH KOREA
Provider Business Practice Location Address Postal Code:
96273
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
315-737-5669
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/22/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C013091 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)