MEDICARE: ANGELIQUE ALLEN M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP2500X	Professional Counselor
3	106H00000X	Marriage & Family Therapist	FL
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1073100921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIQUE ALLEN M.A.

Provider Business Mailing Address
First Line	:	8790 PASEO DE VALENCIA ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-9657
Country	:	US
Telephone Number	:	239-339-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	8790 PASEO DE VALENCIA ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-9657
Country	:	US
Telephone Number	:	239-339-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2020
Last Update Date	:	06/11/2021

Similar Medicare Providers

1417409715 — RACHEL DAVIS LCSW-C
Practice Location Address:

8780 PASEO DE VALENCIA ST
FORT MYERS, FL
33908-9657

Practice Phone: 443-975-9172
Practice Fax:

1710280888 — KELLY MICHELLE WOOD COTA
Practice Location Address:

8528 KILLEEN RUN
FORT WAYNE, IN
46835-9657

Practice Phone: 260-414-0079
Practice Fax:

1205701778 — MELANIE ANNE GREY
Practice Location Address:

9981 S HEALTHPARK DR
FORT MYERS, FL
33908-3618

Practice Phone: 239-343-5000
Practice Fax:

1700748936 — KALYN LINDGREN
Practice Location Address:

9981 S HEALTHPARK DR
FORT MYERS, FL
33908-3618

Practice Phone: 239-343-6260
Practice Fax: 239-343-6259

1841138096 — LESLEEN RUFFNER
Practice Location Address:

13880 SHELL POINT PLZ
FORT MYERS, FL
33908-3503

Practice Phone: 239-297-6631
Practice Fax:

1245917541 — ADAM THOMAS TANNER DDS
Practice Location Address:

16960 ALICO MISSION WAY
FORT MYERS, FL
33908-4844

Practice Phone: 631-346-9831
Practice Fax:

Directions to “ ANGELIQUE ALLEN M.A.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.