Provider Demographics
NPI:1689388878
Name:CARROLL, ANGEL DENNY (SW)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:DENNY
Last Name:CARROLL
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 VIRGILINA RD
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-4469
Mailing Address - Country:US
Mailing Address - Phone:336-647-4141
Mailing Address - Fax:
Practice Address - Street 1:1766 VIRGILINA RD
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-4469
Practice Address - Country:US
Practice Address - Phone:336-647-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker