Provider Demographics
NPI:1023765070
Name:SCOGGIN, ANGELA M (LLMFT, MAPSY)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:SCOGGIN
Suffix:
Gender:F
Credentials:LLMFT, MAPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16498 S RED BUD TRL
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107-9466
Mailing Address - Country:US
Mailing Address - Phone:269-362-5762
Mailing Address - Fax:
Practice Address - Street 1:1030 MINERS RD STE A
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9709
Practice Address - Country:US
Practice Address - Phone:269-408-8474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4151001051APP22101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional