Individual
ANGELA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1143 FAIRWAY ST STE 3, BOWLING GREEN, KY 42103-2452
(270) 904-6307
(270) 904-6314
Mailing address
1775 TEMPERANCE RD, FRANKLIN, KY 42134-7294
(270) 792-1563
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3923
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3923
LCSW
KY
05
—
7100365090
—
KY
Enumeration date
02/03/2009
Last updated
03/28/2018
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