Provider Demographics
NPI:1932530292
Name:ALLISON, ANGELA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:BALDERAS
Other - Last Name:ALLISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:414 SCARLET SAGE DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6426
Mailing Address - Country:US
Mailing Address - Phone:832-301-1434
Mailing Address - Fax:866-319-7185
Practice Address - Street 1:2000 TEXAS AVE
Practice Address - Street 2:STE 900
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-8475
Practice Address - Country:US
Practice Address - Phone:713-528-2328
Practice Address - Fax:713-533-1408
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical