Provider Demographics
NPI:1619341591
Name:BOND, ANGELA DELOATCH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:DELOATCH
Last Name:BOND
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 640
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-0640
Mailing Address - Country:US
Mailing Address - Phone:252-536-5440
Mailing Address - Fax:252-536-5444
Practice Address - Street 1:919 JR HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SCOTLAND NECK
Practice Address - State:NC
Practice Address - Zip Code:27874-1219
Practice Address - Country:US
Practice Address - Phone:252-826-3143
Practice Address - Fax:252-826-3110
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0098331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical