Provider Demographics
NPI:1831340793
Name:HOUSER, ANGELA KAYE (BA,MS, LCASA)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAYE
Last Name:HOUSER
Suffix:
Gender:F
Credentials:BA,MS, LCASA
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:KAYE
Other - Last Name:HOUSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PARENT EDUCATOR
Mailing Address - Street 1:802 N RANSOM ST
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-1957
Mailing Address - Country:US
Mailing Address - Phone:704-930-1935
Mailing Address - Fax:
Practice Address - Street 1:2020 REMOUNT RD
Practice Address - Street 2:STE 100W
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7478
Practice Address - Country:US
Practice Address - Phone:704-930-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 103K00000X, 171M00000X, 101YA0400X, 106H00000X, 2355S0801X, 172V00000X, 103K00000X, 171M00000X
NCLCAS-23448101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No172V00000XOther Service ProvidersCommunity Health Worker