Provider Demographics
NPI:1053560755
Name:BRIDGES, ANGELA KAREN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAREN
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7304 MITHRASDOWNE CT
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-5396
Mailing Address - Country:US
Mailing Address - Phone:919-671-3317
Mailing Address - Fax:919-761-1244
Practice Address - Street 1:7304 MITHRASDOWNE CT
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5396
Practice Address - Country:US
Practice Address - Phone:919-671-3317
Practice Address - Fax:919-761-1244
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0060381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical