Provider Demographics
NPI:1376053157
Name:ANGELIS, EKATERINI WENDY (LMFT)
Entity Type:Individual
Prefix:
First Name:EKATERINI
Middle Name:WENDY
Last Name:ANGELIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 SW MUIR DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-4160
Mailing Address - Country:US
Mailing Address - Phone:714-876-5996
Mailing Address - Fax:
Practice Address - Street 1:3009 SW MUIR DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-4160
Practice Address - Country:US
Practice Address - Phone:714-876-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2023-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA120127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist