Healthcare Provider Details

I. General information

NPI: 1740392034
Provider Name (Legal Business Name): ANGELA CHRISTINE BELLINGHAUSEN LPC, LIMHP LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 SOUTHPARK RD
FLORISSANT CO
80816-8991
US

IV. Provider business mailing address

2421 SOUTHPARK RD
FLORISSANT CO
80816-8991
US

V. Phone/Fax

Practice location:
  • Phone: 402-253-4277
  • Fax:
Mailing address:
  • Phone: 402-253-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number145
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number339
License Number StateNE
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number.0019291
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: