Provider Demographics
NPI:1972141703
Name:PERRY-MARTIN, ANGIE (LPC)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:PERRY-MARTIN
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 KILIMANJARO DR
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-5302
Mailing Address - Country:US
Mailing Address - Phone:720-924-1155
Mailing Address - Fax:
Practice Address - Street 1:1019 8TH ST STE 310
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5858
Practice Address - Country:US
Practice Address - Phone:720-924-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health