Provider Demographics
NPI:1518278407
Name:CARR, ANGELA R (LSCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:CARR
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:R
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1358
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1358
Mailing Address - Country:US
Mailing Address - Phone:316-293-3429
Mailing Address - Fax:316-293-1882
Practice Address - Street 1:8533 E 32ND ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2611
Practice Address - Country:US
Practice Address - Phone:316-293-2622
Practice Address - Fax:316-293-1866
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical