Provider Demographics
NPI:1780173781
Name:MACDOUGALL, ANGELA NICOLE (LMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICOLE
Last Name:MACDOUGALL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 SUNGLOW DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-6143
Mailing Address - Country:US
Mailing Address - Phone:530-262-2902
Mailing Address - Fax:
Practice Address - Street 1:3545 SUNGLOW DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-6143
Practice Address - Country:US
Practice Address - Phone:530-262-2902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99331101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health