Provider Demographics
NPI:1558452862
Name:STERN, ANGELA ROSLYN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ROSLYN
Last Name:STERN
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 1:1770 W REGENTS PARK RD
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2542
Mailing Address - Country:US
Mailing Address - Phone:410-451-1851
Mailing Address - Fax:
Practice Address - Street 1:2134 ESPEY CT STE 3
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2437
Practice Address - Country:US
Practice Address - Phone:410-703-0838
Practice Address - Fax:301-261-0963
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2268101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional