MEDICARE: ANGELA YOO M.A., 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
1	101YP2500X	Professional Counselor	86631	TX

General Provider Information

NPI Number	:	1356155980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA YOO M.A., NCC, LPC

Provider Business Mailing Address
First Line	:	5348 OLD JACKSONVILLE HWY APT 418
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-3359
Country	:	US
Telephone Number	:	915-246-9677
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 E SE LOOP 323 STE 304
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-8314
Country	:	US
Telephone Number	:	903-952-3757
Fax Number	:

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

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	02/04/2025

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