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General NPI Number Information
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NPI Number | 1679868236
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Entity Type | Individual
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Provider Name | ANGELA ESSICK DYKES LPC
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Gender | Female
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Dates
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Enumeration Date | 06/12/2011
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Last Update Date | 06/12/2011
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Provider Practice Location Address
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Address Line | 721 W MONTCALM ST
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City | GREENVILLE
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State | MI
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Zip | 48838-1655
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Country | US
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Telephone | 616-225-1060
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Fax | 616-225-1060
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Provider Business Mailing Address
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Address Line | 721 W MONTCALM ST
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City | GREENVILLE
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State | MI
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Zip | 48838-1655
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Country | US
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Telephone | 616-225-1060
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Fax | 616-225-1060
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401006572
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License Number State | MI
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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 | 7749
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License Number State | NC
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