Provider Demographics
NPI:1093931859
Name:ADAMS, ANGELA CAMILLE (LPC-S, BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:CAMILLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC-S, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21765 MERCHANTS WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2511
Mailing Address - Country:US
Mailing Address - Phone:832-233-6773
Mailing Address - Fax:832-213-4444
Practice Address - Street 1:21765 MERCHANTS WAY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-2511
Practice Address - Country:US
Practice Address - Phone:832-233-6773
Practice Address - Fax:832-213-4444
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-05-2113103K00000X
TX1380103K00000X
TX19463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional