Provider Demographics
NPI:1063991891
Name:ANDREWS, ANGELA MADDOX (LCSW-A)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MADDOX
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E BOGUE SOUND DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28512-5513
Mailing Address - Country:US
Mailing Address - Phone:125-234-2088
Mailing Address - Fax:
Practice Address - Street 1:3820 BRIDGES ST STE B
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2979
Practice Address - Country:US
Practice Address - Phone:252-499-9637
Practice Address - Fax:252-499-9641
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO127181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical