Provider Demographics
NPI:1083473920
Name:WARD, ANGELIA (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:ANGELIA
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:212 CONROE DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1950
Mailing Address - Country:US
Mailing Address - Phone:936-760-1880
Mailing Address - Fax:
Practice Address - Street 1:2611 ROYAL FIELD LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-4585
Practice Address - Country:US
Practice Address - Phone:832-274-0831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional