Provider Demographics
NPI:1225887706
Name:MCPHERSON, ANGELA (MA, LAPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:MA, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SETH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-1645
Mailing Address - Country:US
Mailing Address - Phone:317-445-6964
Mailing Address - Fax:
Practice Address - Street 1:707 WHITLOCK AVENUE NW
Practice Address - Street 2:D-34
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064
Practice Address - Country:US
Practice Address - Phone:404-731-8621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health