Provider Demographics
NPI:1467860254
Name:KALOUDIS, ANGELA E (LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:KALOUDIS
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 R COMMONWEALTH AVE STE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1233
Mailing Address - Country:US
Mailing Address - Phone:617-278-6380
Mailing Address - Fax:
Practice Address - Street 1:870 R COMMONWEALTH AVE STE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1233
Practice Address - Country:US
Practice Address - Phone:617-278-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health