Healthcare Provider Details

I. General information

NPI: 1700184199
Provider Name (Legal Business Name): ANGELA LAMPO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 BUIST RD STE 103
MILFORD PA
18337-9311
US

IV. Provider business mailing address

159 SANTOS DR
MILFORD PA
18337-6537
US

V. Phone/Fax

Practice location:
  • Phone: 570-590-2194
  • Fax:
Mailing address:
  • Phone: 570-590-2194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC012644
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH002986
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: