Provider Demographics
NPI:1962175489
Name:MCCRIGHT, ANGELIA
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:
Last Name:MCCRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 SE SHARON DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-3410
Mailing Address - Country:US
Mailing Address - Phone:515-897-8312
Mailing Address - Fax:
Practice Address - Street 1:1850 SW PLAZA SHOPS LN STE D
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7168
Practice Address - Country:US
Practice Address - Phone:515-897-8312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health