Provider Demographics
NPI:1659679116
Name:CHARTIER, ANGELA MARIE (LIMHP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:CHARTIER
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11725 ARBOR ST STE 210
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2974
Mailing Address - Country:US
Mailing Address - Phone:402-680-9201
Mailing Address - Fax:531-466-7203
Practice Address - Street 1:11725 ARBOR ST STE 210
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2974
Practice Address - Country:US
Practice Address - Phone:402-680-9201
Practice Address - Fax:402-333-0860
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1681101YP2500X
NE9356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional