Provider Demographics
NPI:1609161462
Name:METCALF, ANGELA KAY (LPC APPLICANT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAY
Last Name:METCALF
Suffix:
Gender:F
Credentials:LPC APPLICANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 N. SPRING STREET
Mailing Address - Street 2:
Mailing Address - City:CANEY
Mailing Address - State:KS
Mailing Address - Zip Code:67333
Mailing Address - Country:US
Mailing Address - Phone:918-907-1081
Mailing Address - Fax:
Practice Address - Street 1:704 N. SPRING STREET
Practice Address - Street 2:
Practice Address - City:CANEY
Practice Address - State:KS
Practice Address - Zip Code:67333
Practice Address - Country:US
Practice Address - Phone:918-907-1081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional