Provider Demographics
NPI:1760716963
Name:GEHRES, ANGELA P (MACM, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:P
Last Name:GEHRES
Suffix:
Gender:F
Credentials:MACM, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 BETHEL RD FL 1
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2690
Mailing Address - Country:US
Mailing Address - Phone:614-459-3003
Mailing Address - Fax:614-459-3004
Practice Address - Street 1:8387 GALLOP DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9570
Practice Address - Country:US
Practice Address - Phone:614-459-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0800411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional