Provider Demographics
NPI:1386746246
Name:SMILEY, ANGELIA LYNETTE (MA LPC)
Entity type:Individual
Prefix:MS
First Name:ANGELIA
Middle Name:LYNETTE
Last Name:SMILEY
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 1:12584 DARBY BROOKE CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2485
Mailing Address - Country:US
Mailing Address - Phone:703-490-9962
Mailing Address - Fax:703-490-9964
Practice Address - Street 1:12584 DARBY BROOKE CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2485
Practice Address - Country:US
Practice Address - Phone:703-490-9962
Practice Address - Fax:703-490-9964
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
177301OtherANTHEM
238333OtherAPS
530294OtherNCPPO
7418169OtherMAMSI
7418169OtherUNITED HEALTHCARE
J2680001OtherCAREFIRST BCBS