Provider Demographics
NPI:1609303650
Name:WALDROP, ANGELA LYNN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LYNN
Last Name:WALDROP
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 MILLWOOD AVE BLDG B
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1334
Mailing Address - Country:US
Mailing Address - Phone:803-814-6218
Mailing Address - Fax:855-490-9560
Practice Address - Street 1:2917 MILLWOOD AVE BLDG B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1334
Practice Address - Country:US
Practice Address - Phone:803-814-6218
Practice Address - Fax:855-490-9560
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-20
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1833106H00000X
SC4680106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist