Provider Demographics
NPI:1376090019
Name:ANGELOPOULOS, AUDREY (LCMHC)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:ANGELOPOULOS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:529 MAIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-1122
Mailing Address - Country:US
Mailing Address - Phone:617-478-3895
Mailing Address - Fax:
Practice Address - Street 1:529 MAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-1122
Practice Address - Country:US
Practice Address - Phone:617-478-3895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator