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NPI Code Detail

MEDICARE: MRS. ANGELA RENE SASSEVILLE MA, NCC, LPC

MEDICARE: MRS. ANGELA RENE SASSEVILLE MA, NCC, LPC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2106H00000XMarriage & Family Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14931OTHERCOLICENSED PROFESSIONAL COUNSELOR

General Provider Information

NPI Number : 1184808883
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA RENE SASSEVILLE MA, NCC, LPC
Provider Business Mailing Address
First Line : 3557 W 44TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-1313
Country : US
Telephone Number : 303-875-0386
Fax Number : 303-455-9667
Provider Business Practice Location Address
First Line : 3557 W 44TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80211-1313
Country : US
Telephone Number : 303-875-0386
Fax Number : 303-455-9667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2007
Last Update Date : 08/11/2009

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