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NPI Code Detail

MEDICARE: MR. ANGELO LUIS CABRERA LPC

MEDICARE:  MR. ANGELO LUIS CABRERA  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
1101Y00000XCounselor0701007627VA
2101YP2500XProfessional Counselor0701007627VA
3101Y00000XCounselorXXXXXXXXXXXVA

Other Identifiers

General Provider Information

NPI Number : 1548764582
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANGELO LUIS CABRERA LPC
Provider Business Mailing Address
First Line : 5300 NEWBYS WOOD TRL
Second Line :
City : CHESTERFIELD
State : VA
Zip : 23832-7500
Country : US
Telephone Number : 804-836-7273
Fax Number :
Provider Business Practice Location Address
First Line : 7825 MIDLOTHIAN TPKE STE 203
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-5247
Country : US
Telephone Number : 229-412-8125
Fax Number : 804-621-2292
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2018
Last Update Date : 06/11/2019

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