Provider Demographics
NPI:1093434854
Name:RASCOE, ANGELA KNOX (LCMHCA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KNOX
Last Name:RASCOE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1284
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-1284
Mailing Address - Country:US
Mailing Address - Phone:910-795-7374
Mailing Address - Fax:
Practice Address - Street 1:1123 VILLAGE RD NE
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-3109
Practice Address - Country:US
Practice Address - Phone:910-795-7374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17901101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor