Provider Demographics
NPI:1053639716
Name:SARAFIN, ANGELA KAREN (LMFT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAREN
Last Name:SARAFIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 8TH ST NW
Mailing Address - Street 2:APT 630
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20004-2110
Mailing Address - Country:US
Mailing Address - Phone:202-580-8492
Mailing Address - Fax:
Practice Address - Street 1:726 7TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2739
Practice Address - Country:US
Practice Address - Phone:202-580-8492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64650101YM0800X
TX201152106H00000X
DC137106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12138812OtherCAQH
TX8991BHOtherBLUE CROSS BLUE SHIELD