Provider Demographics
NPI:1427503309
Name:PHILLIPS, ANGELA (LMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:PHILLIPS
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 1:8088 W WHITNEY DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6564
Mailing Address - Country:US
Mailing Address - Phone:602-344-5287
Mailing Address - Fax:
Practice Address - Street 1:5825 E CALLE GUADALUPE
Practice Address - Street 2:
Practice Address - City:GUADALUPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2664
Practice Address - Country:US
Practice Address - Phone:833-855-9973
Practice Address - Fax:480-344-6001
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2024-04-26
Deactivation Date:2019-12-16
Deactivation Code:
Reactivation Date:2024-04-24
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-15186106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist