Southerland, Angela Gail

Southerland, Angela Gail is an sole proprietor health care provider with primary practice located at 635 Vass Rd , Raeford NC 28376-8412. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Southerland, Angela Gail can be contacted via phone (901) 670-6567.

Contact Information

Primary practice address
635 Vass Rd Raeford NC 28376-8412
Phone: (901) 670-6567
Fax: (910) 904-2931
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X North Carolina
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1568641710
LBN Legal business name Southerland, Angela Gail
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2007
Last updated Oct 27th, 2007 - about 17 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 1568641710 NPPES
North Carolina MEDICAID 38
North Carolina MEDICAID 10
North Carolina MEDICAID 30
North Carolina MEDICAID 32
North Carolina MEDICAID 17
North Carolina MEDICAID 25
North Carolina MEDICAID 33
North Carolina MEDICAID 34
North Carolina MEDICAID 347C00000

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