Provider Demographics
NPI:1730556127
Name:MAESTAS, ANGELA MARI (LAC, LPCC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARI
Last Name:MAESTAS
Suffix:
Gender:F
Credentials:LAC, LPCC
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:MAESTAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, LPCC
Mailing Address - Street 1:13400 FILLMORE CT
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-1329
Mailing Address - Country:US
Mailing Address - Phone:720-217-9937
Mailing Address - Fax:
Practice Address - Street 1:13400 FILLMORE CT
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-1329
Practice Address - Country:US
Practice Address - Phone:720-217-9937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB0007919101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)