Provider Demographics
NPI:1851717656
Name:MCMILLIAN, ANGELA (LPCA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MCMILLIAN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115A MCMILLIAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28340-8227
Mailing Address - Country:US
Mailing Address - Phone:910-740-5451
Mailing Address - Fax:
Practice Address - Street 1:115A MCMILLIAN DRIVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340-8227
Practice Address - Country:US
Practice Address - Phone:910-740-5451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional