Healthcare Provider Details

I. General information

NPI: 1871872218
Provider Name (Legal Business Name): ANGELA NICOLE DOCKINS M.ED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2458 OLD DORSETT RD STE 110
MARYLAND HEIGHTS MO
63043-2423
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 855-364-0438
  • Fax: 636-939-2551
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2011006413
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: