Provider Demographics
NPI:1487745873
Name:PAOLI, ANGELA MARIA (MSW (LICSW))
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIA
Last Name:PAOLI
Suffix:
Gender:F
Credentials:MSW (LICSW)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 RYE CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7632
Mailing Address - Country:US
Mailing Address - Phone:802-654-7607
Mailing Address - Fax:
Practice Address - Street 1:27 RYE CIR
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7632
Practice Address - Country:US
Practice Address - Phone:802-654-7607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00007171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN1888Medicaid
VTOTH000Medicare UPIN
VT0VN1888Medicaid