Provider Demographics
NPI:1821642950
Name:ABELLA, ANGELO ISIP (LPC-SUPERVISOR)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:ISIP
Last Name:ABELLA
Suffix:
Gender:M
Credentials:LPC-SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 EXCALIBUR CIR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-3625
Mailing Address - Country:US
Mailing Address - Phone:214-708-3330
Mailing Address - Fax:
Practice Address - Street 1:3301 EXCALIBUR CIR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-3625
Practice Address - Country:US
Practice Address - Phone:214-708-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional