Provider Demographics
NPI:1841571148
Name:DOUGLAS, ANGELA GRACE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:GRACE
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 S WADSWORTH BLVD STE 1-201
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4330
Mailing Address - Country:US
Mailing Address - Phone:720-442-0031
Mailing Address - Fax:720-792-4572
Practice Address - Street 1:777 S WADSWORTH BLVD STE 1-201
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4330
Practice Address - Country:US
Practice Address - Phone:720-442-0031
Practice Address - Fax:720-792-4572
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3736101YP2500X
COLPC0013676101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional