Provider Demographics
NPI:1134712870
Name:LANDRUM, ANGELA FARRAH (LPC, LCDC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:FARRAH
Last Name:LANDRUM
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 BROADWAY AVE J
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550
Mailing Address - Country:US
Mailing Address - Phone:409-203-2008
Mailing Address - Fax:
Practice Address - Street 1:2727 BROADWAY AVE J
Practice Address - Street 2:SUITE 102
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550
Practice Address - Country:US
Practice Address - Phone:409-203-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-13
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15541101YA0400X
TX81072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)