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Individual

MR. ANTHONY M WOODALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LPC, LCAS

Contact information

Practice address
111 N 2ND ST, SMITHFIELD, NC 27577-3933
(919) 938-0921
(919) 938-3807
Mailing address
PO BOX 1835, SMITHFIELD, NC 27577-1835
(919) 938-0921
(919) 938-3807

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
632
NC
101YP2500X
Professional Counselor
3041
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0177C
BCBSNC GROUP
NC
01
1165Y
3
NC
01
2076854
2
NC
01
577331
VALUE OPTION
05
6102389
NC
Enumeration date
06/06/2006
Last updated
09/11/2025
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