Provider Demographics
NPI:1275258287
Name:HIRSCH, ANGELIA M (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:M
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 LIME ROCK DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-6332
Mailing Address - Country:US
Mailing Address - Phone:913-287-9505
Mailing Address - Fax:
Practice Address - Street 1:2005 LIME ROCK DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-6332
Practice Address - Country:US
Practice Address - Phone:913-287-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional