Provider Demographics
NPI:1407090020
Name:GREEN, ANGELA P (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:P
Last Name:GREEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:PAGE
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:4225 OFFICE PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3628
Mailing Address - Country:US
Mailing Address - Phone:214-808-3061
Mailing Address - Fax:
Practice Address - Street 1:14205 N. MO PAC EXPY
Practice Address - Street 2:STE 570 PMB 352862
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-6529
Practice Address - Country:US
Practice Address - Phone:469-502-5770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
TX83886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst