Provider Demographics
NPI:1326760513
Name:ORTIZ, ANGELA MARIA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6736 214TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2522
Mailing Address - Country:US
Mailing Address - Phone:917-617-4402
Mailing Address - Fax:
Practice Address - Street 1:8812 ROOSEVELT AVE FL 2
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7800
Practice Address - Country:US
Practice Address - Phone:718-898-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health