Provider Demographics
NPI:1306837489
Name:WALDON, ANN P (LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:P
Last Name:WALDON
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CONNER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7038
Mailing Address - Country:US
Mailing Address - Phone:919-932-3908
Mailing Address - Fax:
Practice Address - Street 1:101 CONNER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7038
Practice Address - Country:US
Practice Address - Phone:919-932-3908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0001801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002108Medicaid
NC2860084Medicare UPIN