Provider Demographics
NPI:1306627757
Name:MENKE, ANGELA (LMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MENKE
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 1:14546 BROOK HOLLOW BLVD # 419
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3810
Mailing Address - Country:US
Mailing Address - Phone:210-446-8582
Mailing Address - Fax:210-783-7492
Practice Address - Street 1:121 OLD SAN ANTONIO RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3415
Practice Address - Country:US
Practice Address - Phone:830-816-2425
Practice Address - Fax:830-249-8714
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204221106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist