Healthcare Provider Details

I. General information

NPI: 1780965137
Provider Name (Legal Business Name): ANGELA L ALLEN M.A., CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13375 UNIVERSITY AVE STE 201
CLIVE IA
50325-8260
US

IV. Provider business mailing address

13375 UNIVERSITY AVE STE 201
CLIVE IA
50325-8260
US

V. Phone/Fax

Practice location:
  • Phone: 515-207-0310
  • Fax:
Mailing address:
  • Phone: 515-207-0310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001420
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: