Individual
MRS. ANGELA HENDERSON SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCMHC, NCC
Contact information
Practice address
2405 NASH ST NW STE D, WILSON, NC 27896-1634
(252) 319-5454
(252) 376-1009
Mailing address
2405 NASH ST NW STE D, WILSON, NC 27896-1634
(252) 319-5454
(252) 376-1009
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
7879
NC
101YM0800X
Mental Health Counselor
7879
NC
101YP2500X
Professional Counselor
Primary
7879
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376989756
BCBS
NC
01
—
1568786424
BCBS
NC
01
—
506455
TRICARE
NC
Enumeration date
03/22/2010
Last updated
05/05/2025
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