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General NPI Number Information
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NPI Number | 1548764582
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Entity Type | Individual
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Provider Name | ANGELO LUIS CABRERA LPC
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Gender | Male
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 7825 MIDLOTHIAN TPKE STE 203
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-5247
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Country | US
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Telephone | 229-412-8125
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Fax | 804-621-2292
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Provider Business Mailing Address
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Address Line | 5300 NEWBYS WOOD TRL
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City | CHESTERFIELD
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State | VA
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Zip | 23832-7500
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Country | US
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Telephone | 804-836-7273
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0701007627
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701007627
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | XXXXXXXXXXX
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License Number State | VA
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