Provider Demographics
NPI:1497790299
Name:MCDOWELL, ANGELA L (LCPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:L
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-1324
Mailing Address - Country:US
Mailing Address - Phone:618-466-7471
Mailing Address - Fax:
Practice Address - Street 1:604 E BROADWAY
Practice Address - Street 2:SUITE 302, ROOM 1
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6322
Practice Address - Country:US
Practice Address - Phone:618-465-9747
Practice Address - Fax:618-465-9796
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional