Provider Demographics
NPI:1730059809
Name:BARE, ANGIE (MA, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:BARE
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 WILLIAMS DR STE 220
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2739
Mailing Address - Country:US
Mailing Address - Phone:512-588-2429
Mailing Address - Fax:512-727-7646
Practice Address - Street 1:2913 WILLIAMS DR STE 220
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2739
Practice Address - Country:US
Practice Address - Phone:512-588-2429
Practice Address - Fax:512-727-7646
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91971101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health