Provider Demographics
NPI:1437489457
Name:SALYERS, ANGELA GRAY (MA, MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:GRAY
Last Name:SALYERS
Suffix:
Gender:F
Credentials:MA, MS, LPC
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:ELIZABETH
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:323 DE LA MARE
Mailing Address - Street 2:ROOM 12
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532
Mailing Address - Country:US
Mailing Address - Phone:646-220-8561
Mailing Address - Fax:
Practice Address - Street 1:323 DE LA MARE
Practice Address - Street 2:ROOM 12
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532
Practice Address - Country:US
Practice Address - Phone:646-220-8561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MS2444101YP2500X
ALLPC4217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018214Medicaid