Provider Demographics
NPI:1548484744
Name:CALHOUN, ANGELIQUE N (LICSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELIQUE
Middle Name:N
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5412 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3438
Mailing Address - Country:US
Mailing Address - Phone:301-559-9542
Mailing Address - Fax:
Practice Address - Street 1:1250 U ST NW
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-7522
Practice Address - Country:US
Practice Address - Phone:202-673-2042
Practice Address - Fax:202-673-7642
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500777751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical