Provider Demographics
NPI:1922031129
Name:HOLOUBEK, ANGELA NICHOLE (LSCSW, RPT)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:NICHOLE
Last Name:HOLOUBEK
Suffix:
Gender:F
Credentials:LSCSW, RPT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:LETS TALK THERAPY AND SUPERVISION INC
Mailing Address - Street 2:2458 W NEWELL ST
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-5108
Mailing Address - Country:US
Mailing Address - Phone:316-691-7201
Mailing Address - Fax:316-847-7082
Practice Address - Street 1:LETS TALK THERAPY AND SUPERVISION INC
Practice Address - Street 2:2458 W NEWELL ST
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-5108
Practice Address - Country:US
Practice Address - Phone:316-691-7201
Practice Address - Fax:316-847-7082
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200438180GMedicaid
KS006903008Medicare UPIN
KS200438180GMedicaid