Provider Demographics
NPI:1508042433
Name:INMAN, ANGELA FAYE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:FAYE
Last Name:INMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LOOP ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-4062
Mailing Address - Country:US
Mailing Address - Phone:910-592-2221
Mailing Address - Fax:910-592-2229
Practice Address - Street 1:100 LOOP ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4062
Practice Address - Country:US
Practice Address - Phone:910-592-2221
Practice Address - Fax:910-592-2229
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0059061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106952Medicaid
$$$$$$$$$OtherTRICARE
NC6106952Medicaid