Provider Demographics
NPI:1205354487
Name:WELCH, ANGELA L (LMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:L
Last Name:WELCH
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 WALL ST STE 22
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2572
Mailing Address - Country:US
Mailing Address - Phone:219-928-8211
Mailing Address - Fax:
Practice Address - Street 1:402 WALL ST STE 22
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2572
Practice Address - Country:US
Practice Address - Phone:219-928-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002101A106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300104976Medicaid