Provider Demographics
NPI:1942994033
Name:DEVEZIN, ANGELE NICHELE (LMSW)
Entity type:Individual
Prefix:
First Name:ANGELE
Middle Name:NICHELE
Last Name:DEVEZIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 CLEARBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3436
Mailing Address - Country:US
Mailing Address - Phone:504-421-6438
Mailing Address - Fax:
Practice Address - Street 1:764 CLEARBROOK AVE
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78108-3436
Practice Address - Country:US
Practice Address - Phone:504-421-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110017104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker