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NPI Code Detail

MEDICARE: ANGIE DIEHL MA, LPC, NCC

MEDICARE:   ANGIE  DIEHL  MA, LPC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4831CO

General Provider Information

NPI Number : 1023618675
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGIE DIEHL MA, LPC, NCC
Provider Business Mailing Address
First Line : PO BOX 63801
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80962-3801
Country : US
Telephone Number : 719-660-6117
Fax Number :
Provider Business Practice Location Address
First Line : 7615 AUSTIN BLUFFS PKWY UNIT 100
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-2901
Country : US
Telephone Number : 719-660-6117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2020
Last Update Date : 10/31/2020

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