Individual
MS. ANGELA MAE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1165 UNION ST NE, SUITE 200, SALEM, OR 97301-4693
(503) 399-2424
(503) 375-7429
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
(503) 375-7429
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4312
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500642794
—
OR
01
—
L4312
OREGON LICENSE NUMBER
OR
Enumeration date
03/23/2006
Last updated
12/19/2016
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