Provider Demographics
NPI:1689119182
Name:WESTHEAD, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WESTHEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:MOSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:378 WOODBINE AVE SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6047
Mailing Address - Country:US
Mailing Address - Phone:330-518-7068
Mailing Address - Fax:247-981-2293
Practice Address - Street 1:1914 MERCER AVE
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-2505
Practice Address - Country:US
Practice Address - Phone:724-981-9815
Practice Address - Fax:724-981-2293
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1601928101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)