Healthcare Provider Details

I. General information

NPI: 1295060457
Provider Name (Legal Business Name): ANGELA HOPE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. ANGELA HOPE SHEPARD

II. Dates (important events)

Enumeration Date: 10/06/2009
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4380 S SYRACUSE ST STE 320
DENVER CO
80237-2420
US

IV. Provider business mailing address

4380 S SYRACUSE ST STE 320
DENVER CO
80237-2420
US

V. Phone/Fax

Practice location:
  • Phone: 888-830-0347
  • Fax:
Mailing address:
  • Phone: 888-830-0347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW31348
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09928583
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: