Individual
MARK ANTHONY WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCA
Contact information
Practice address
318 N BRIDGE ST, JONESVILLE, NC 28642-2210
(336) 244-6940
Mailing address
318 N BRIDGE ST, JONESVILLE, NC 28642-2210
(336) 244-6940
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-24872
NC
101YP2500X
Professional Counselor
Primary
QS147274
NC
Other
Enumeration date
04/01/2019
Last updated
09/23/2025
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