Provider Demographics
NPI:1043020225
Name:DOWNS, ANGELA MARIE (LPC-IT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:DOWNS
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-2354
Mailing Address - Country:US
Mailing Address - Phone:262-598-6002
Mailing Address - Fax:
Practice Address - Street 1:625 57TH ST STE 502
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-4146
Practice Address - Country:US
Practice Address - Phone:262-419-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8250226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional