Provider Demographics
NPI:1649397456
Name:WU, ANGELA VINCENT (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:VINCENT
Last Name:WU
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12951 BEL RED RD STE 190
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2698
Mailing Address - Country:US
Mailing Address - Phone:425-462-2776
Mailing Address - Fax:425-462-2860
Practice Address - Street 1:12951 BEL RED RD STE 190
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2698
Practice Address - Country:US
Practice Address - Phone:425-462-2776
Practice Address - Fax:425-462-2860
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010660101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00010660OtherMENTAL HEALTH COUNSELOR
89126OtherNAT. BD. CERT. COUNSELOR
WARC00050123OtherREGISTERED COUNSELOR