Provider Demographics
NPI:1356155980
Name:YOO, ANGELA (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:YOO
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5348 OLD JACKSONVILLE HWY APT 418
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3359
Mailing Address - Country:US
Mailing Address - Phone:915-246-9677
Mailing Address - Fax:
Practice Address - Street 1:1828 E SE LOOP 323 STE 304
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8314
Practice Address - Country:US
Practice Address - Phone:903-952-3757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86631101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional