Provider Demographics
NPI:1346511904
Name:HENSLEY, ANGELA DIANE (MA/EDS LCAS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DIANE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:MA/EDS LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-2801
Mailing Address - Country:US
Mailing Address - Phone:828-245-8886
Mailing Address - Fax:828-245-8818
Practice Address - Street 1:117 W MEDICAL CT
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-5564
Practice Address - Country:US
Practice Address - Phone:828-659-3966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1914101YA0400X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional