Healthcare Provider Details

I. General information

NPI: 1700484896
Provider Name (Legal Business Name): ANGELA LYNN ISAAC MS, LPC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 W MCDOWELL RD APT 1054
PHOENIX AZ
85035-4992
US

IV. Provider business mailing address

6405 W MCDOWELL RD APT 1054 APT 1054
PHOENIX AZ
85035-4992
US

V. Phone/Fax

Practice location:
  • Phone: 480-395-9861
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-24862
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number18-145
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: