Provider Demographics
NPI:1215695150
Name:SHY, ANGELA (LPC, LMHC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:SHY
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW BETHANY BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5238
Mailing Address - Country:US
Mailing Address - Phone:541-209-0283
Mailing Address - Fax:
Practice Address - Street 1:1500 NW BETHANY BLVD STE 310
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5238
Practice Address - Country:US
Practice Address - Phone:503-626-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61587145101YM0800X
390200000X
ORC9855101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program