Provider Demographics
NPI:1770256380
Name:NEWSOM, ANGELEAH (LPC ASSOCIATE)
Entity type:Individual
Prefix:MS
First Name:ANGELEAH
Middle Name:
Last Name:NEWSOM
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:ANGELEAH
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1244 VIRGINIA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78203-1834
Mailing Address - Country:US
Mailing Address - Phone:210-693-4638
Mailing Address - Fax:
Practice Address - Street 1:1244 VIRGINIA BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78203-1834
Practice Address - Country:US
Practice Address - Phone:210-693-4638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health