Angela L Colistra, LCAS, LPC, CRC, CS-I

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC008999 Issued in PA

Practice address

1627 Chew St Ste 101
Allentown, PA 18102-3648

Phone

(610) 969-4370

Fax

(610) 969-3023

NPI assigned

Oct 11, 2007

Last updated

Apr 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Angela L Childers Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Health Partners Community Health Center

  dba VHP - Lehigh Valley Physicians Practice

  • Federally Qualified Health Center (FQHC)
  • Allentown, PA
  • NPI 1932735651
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1538357983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 CHEW ST STE 101",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023648",
            "telephone_number": "610-969-4370",
            "fax_number": "610-969-3023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 Chew St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181045549",
            "country_code": "US",
            "telephone_number": "610-969-3500",
            "fax_number": "610-969-3605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "145 Remount Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035013",
            "country_code": "US",
            "telephone_number": "704-332-9001 x2510",
            "fax_number": "828-263-0995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLISTRA",
        "first_name": "ANGELA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCAS, LPC, CRC, CS-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "6111907",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC008999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "CHILDERS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gina F Colaneri, CRNP
• Margaret Elizabeth Cole, LMFT LICENSED MARRIA
• Theresa Cole
• Michael Coleman
• Sara Colfer, LBS
• College Heights Endoscopy Center LLC
• College Heights Endoscopy Center, LLC
• Daniel Coller, M.D.
• Hannah Collett, LPC
• Padraic Colley, CRNA

• Professional Counselor in Allentown, PA
• Providers in Allentown, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.