Provider Demographics
NPI:1215587456
Name:WARFIELD, ANGELA B (PLPC, CRADC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:WARFIELD
Suffix:
Gender:F
Credentials:PLPC, CRADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-3765
Mailing Address - Country:US
Mailing Address - Phone:573-629-5544
Mailing Address - Fax:
Practice Address - Street 1:12677 HEAVENLY ACRES DR
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:MO
Practice Address - Zip Code:63459-2436
Practice Address - Country:US
Practice Address - Phone:573-248-1372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018020714101YP2500X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health