Small, Angela Henderson

Small, Angela Henderson is an sole proprietor health care provider with primary practice located at 3204 Nash St N Ste B , Wilson NC 27896-3002. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Small, Angela Henderson can be contacted via phone (252) 319-5454.

Contact Information

Primary practice address
3204 Nash St N Ste B Wilson NC 27896-3002
Phone: (252) 319-5454
Fax: (252) 376-1009
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 7879 North Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 7879 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X 7879 North Carolina

Profile Details

NPI number 1568786424
LBN Legal business name Small, Angela Henderson
Credentials MS, LCMHC, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2010
Last updated May 19th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568786424 NPPES
North Carolina Other 1568786424 BCBS
North Carolina Other 1376989756 BCBS
North Carolina MEDICAID 6104468 BCBS
North Carolina Other 506455 BCBS

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