Provider Demographics
NPI:1689499071
Name:TEMPLE, ANGELICA (PLMHP, PCSW)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:TEMPLE
Suffix:
Gender:
Credentials:PLMHP, PCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8424 W CENTER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3138
Mailing Address - Country:US
Mailing Address - Phone:531-600-8874
Mailing Address - Fax:
Practice Address - Street 1:8424 W CENTER RD STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3138
Practice Address - Country:US
Practice Address - Phone:531-600-8874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14089101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health