Provider Demographics
NPI:1194392381
Name:TAYLOR, ANGELA NICHOLE (LPC, MS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICHOLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 MARGATE CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2301
Mailing Address - Country:US
Mailing Address - Phone:281-685-2503
Mailing Address - Fax:
Practice Address - Street 1:1018 MARGATE CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2301
Practice Address - Country:US
Practice Address - Phone:281-685-2503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional