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NPI Code Detail

MEDICARE: ANGELA NICOLE DOCKINS M.ED, LPC

MEDICARE: ANGELA NICOLE DOCKINS M.ED, LPC
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 Counselor
2101YM0800XMental Health Counselor2011006413MO

General Provider Information

NPI Number : 1871872218
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA NICOLE DOCKINS M.ED, LPC
Provider Business Mailing Address
First Line : 1800 COMMUNITY
Second Line :
City : CLINTON
State : MO
Zip : 64735-8804
Country : US
Telephone Number : 660-885-8131
Fax Number :
Provider Business Practice Location Address
First Line : 102 COMPASS POINT DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-4404
Country : US
Telephone Number : 314-206-3900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2011
Last Update Date : 05/30/2025

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