Provider Demographics
NPI:1184808883
Name:SASSEVILLE, ANGELA RENE (MA, NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RENE
Last Name:SASSEVILLE
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:RENE
Other - Last Name:BOHLENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3557 W 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1313
Mailing Address - Country:US
Mailing Address - Phone:303-875-0386
Mailing Address - Fax:303-455-9667
Practice Address - Street 1:3557 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1313
Practice Address - Country:US
Practice Address - Phone:303-875-0386
Practice Address - Fax:303-455-9667
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4931OtherLICENSED PROFESSIONAL COUNSELOR