| Doctor Name: | JODI ERIN DEANGELIS |
| NPI Number: | 1811132517 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LCDP |
| License Number: | C179 |
| Business Practice Address: | 530 N Main St 4th Floor Providence, RI - 029045762 |
| Business Phone Number: | 4014378243 |
| Business Fax Number: | 4012766102 |
| Mailing Address: | 530 N Main St, 4th Floor PROVIDENCE |
| State: | RI |
| Postal Code: | 029045762 |
| Phone Number: | 4014378243 |
| Fax Number: | 4012766102 |
| NPI Enumeration Date: | 12/09/2008 |
| NPI Last Update Date: | 01/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | C179 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | RI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |