Healthcare Provider Details

I. General information

NPI: 1093221004
Provider Name (Legal Business Name): ANGEL D VEST LCSW, LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 W HENDERSON RD SUITE 1222
COLUMBUS OH
43220
US

IV. Provider business mailing address

1985 HENDERSON RD STE 1222
COLUMBUS OH
43220-2401
US

V. Phone/Fax

Practice location:
  • Phone: 303-900-8586
  • Fax:
Mailing address:
  • Phone: 303-900-8586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.161827
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09929437
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2203681
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberTPSW4898
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: