Provider Demographics
NPI:1689957136
Name:CARTWRIGHT, ANGELA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:CARTWRIGHT
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 1848
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-1841
Mailing Address - Country:US
Mailing Address - Phone:479-437-3449
Mailing Address - Fax:479-243-0285
Practice Address - Street 1:1100 N UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6360
Practice Address - Country:US
Practice Address - Phone:888-710-8220
Practice Address - Fax:866-573-0761
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3489-C1041C0700X, 1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR228218719Medicaid