Provider Demographics
NPI:1437211125
Name:BRIDDELL, APRIL SHANELL (LCSW)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:SHANELL
Last Name:BRIDDELL
Suffix:
Gender:F
Credentials:LCSW
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 1163
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1163
Mailing Address - Country:US
Mailing Address - Phone:252-367-1153
Mailing Address - Fax:919-375-2309
Practice Address - Street 1:9302 SAMFORD CT
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:MD
Practice Address - Zip Code:21875-2275
Practice Address - Country:US
Practice Address - Phone:252-367-1153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD257161041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106557Medicaid