Provider Demographics
NPI:1851530505
Name:SHAMSID-DEEN, ANGELA G (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:G
Last Name:SHAMSID-DEEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 LANGSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8057
Mailing Address - Country:US
Mailing Address - Phone:404-593-5127
Mailing Address - Fax:
Practice Address - Street 1:356 LANGSHIRE DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8057
Practice Address - Country:US
Practice Address - Phone:404-593-5127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 005177101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional