Provider Demographics
NPI:1740624295
Name:HOUSTON, ANGELA ARMANDA (LPC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:ARMANDA
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 SKYLAR CT
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-7167
Mailing Address - Country:US
Mailing Address - Phone:919-556-9958
Mailing Address - Fax:
Practice Address - Street 1:8368 SIX FORKS RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5083
Practice Address - Country:US
Practice Address - Phone:919-592-3650
Practice Address - Fax:919-277-4627
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4771101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC101YP2500XMedicaid