Provider Demographics
NPI:1457249567
Name:ANGELL, VERONICA LEIGH (LADC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:LEIGH
Last Name:ANGELL
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 W LAKE ST UNIT 310
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-6808
Mailing Address - Country:US
Mailing Address - Phone:763-607-6020
Mailing Address - Fax:
Practice Address - Street 1:3118 W LAKE ST UNIT 310
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-6808
Practice Address - Country:US
Practice Address - Phone:763-607-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YM0800X
MN306752101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health