Individual
ANGELA C BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
411 MAIN ST W, AHOSKIE, NC 27910-3321
(252) 862-4411
(252) 862-4414
Mailing address
228 MAIN ST E, AHOSKIE, NC 27910-3418
(252) 209-0388
(252) 209-0488
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2246
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142CC
BC BS
NC
05
—
6107280
—
NC
Enumeration date
01/10/2007
Last updated
07/08/2007
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