Provider Demographics
NPI:1629495619
Name:ANGULO DE ARAUJO, LUCILA C (MA, LPC)
Entity Type:Individual
Prefix:
First Name:LUCILA
Middle Name:C
Last Name:ANGULO DE ARAUJO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1526
Mailing Address - Country:US
Mailing Address - Phone:262-637-8888
Mailing Address - Fax:262-637-0695
Practice Address - Street 1:503 WISCONSIN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4147
Practice Address - Country:US
Practice Address - Phone:920-458-5726
Practice Address - Fax:920-458-5826
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5513-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100037620Medicaid