=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629495619
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUCILA C ANGULO DE ARAUJO MA, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2014
-----------------------------------------------------
Last Update Date | 02/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 503 WISCONSIN AVE SUITE 2
-----------------------------------------------------
City | SHEBOYGAN
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53081-4147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-458-5726
-----------------------------------------------------
Fax | 920-458-5826
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 WISCONSIN AVE
-----------------------------------------------------
City | RACINE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53403-1526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-637-8888
-----------------------------------------------------
Fax | 262-637-0695
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 5513-125
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------