Provider Demographics
NPI:1093221004
Name:VEST, ANGEL D (LCSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:D
Last Name:VEST
Suffix:
Gender:F
Credentials:LCSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22959 E SMOKY HILL RD APT M108
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6741
Mailing Address - Country:US
Mailing Address - Phone:740-972-5150
Mailing Address - Fax:
Practice Address - Street 1:9403 CROWN CREST BLVD STE 300TVW
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8882
Practice Address - Country:US
Practice Address - Phone:303-269-4410
Practice Address - Fax:303-269-4411
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161519101YA0400X
OHS.1903882101YM0800X
COCSW.09929437104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker