Provider Demographics
NPI:1902088412
Name:CASANOVA, ANGELA DENISE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DENISE
Last Name:CASANOVA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9206 PERKINS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2849
Mailing Address - Country:US
Mailing Address - Phone:210-535-4956
Mailing Address - Fax:
Practice Address - Street 1:1222 N MAIN AVE STE 740
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5711
Practice Address - Country:US
Practice Address - Phone:210-271-7411
Practice Address - Fax:210-271-9414
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61328101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional