Provider Demographics
NPI:1598219594
Name:ZUMBEK, ANGELA (MA, LCPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ZUMBEK
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2396 W NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61604-3111
Mailing Address - Country:US
Mailing Address - Phone:309-676-6305
Mailing Address - Fax:309-676-6519
Practice Address - Street 1:2396 W NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61604-3111
Practice Address - Country:US
Practice Address - Phone:309-676-6305
Practice Address - Fax:309-676-6519
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional