Provider Demographics
NPI:1962897165
Name:DELAROSA, ANGEL (MA,LPC)
Entity type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:
Last Name:DELAROSA
Suffix:
Gender:M
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 1:1617 HUGE OAKS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3421
Mailing Address - Country:US
Mailing Address - Phone:713-253-1108
Mailing Address - Fax:
Practice Address - Street 1:1617 HUGE OAKS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3421
Practice Address - Country:US
Practice Address - Phone:713-253-1108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68086101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional