Provider Demographics
NPI:1902110125
Name:LILES, ANGELIKA MARKS (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:ANGELIKA
Middle Name:MARKS
Last Name:LILES
Suffix:
Gender:F
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 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:116 S LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3657
Practice Address - Country:US
Practice Address - Phone:910-895-2462
Practice Address - Fax:910-895-9896
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20390-A101YA0400X
NC7796101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1902110125OtherHUMANA
NC1902110125Medicaid
NC19CFBOtherBCBS
NC601039-499OtherMAGELLAN
NC1902110125OtherUBH