MEDICARE: MRS. ANGELA MARI MAESTAS LPC, LAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACB0007919	CO
2	101YP2500X	Professional Counselor	LPC.0021602	CO

General Provider Information

NPI Number	:	1730556127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA MARI MAESTAS LPC, LAC

Provider Business Mailing Address
First Line	:	16320 SAINT PAUL DR
Second Line	:
City	:	THORNTON
State	:	CO
Zip	:	80602-6671
Country	:	US
Telephone Number	:	720-217-9937
Fax Number	:

Provider Business Practice Location Address
First Line	:	7050 W 120TH AVE UNIT 30
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-7604
Country	:	US
Telephone Number	:	720-217-9937
Fax Number	:

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

Provider Enumeration Date	:	09/01/2015
Last Update Date	:	02/02/2026

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