Provider Demographics
NPI:1912539560
Name:SEABROOKS, ANGELA DAVINA (LCMHC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:DAVINA
Last Name:SEABROOKS
Suffix:
Gender:F
Credentials:LCMHC
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 2522
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-2522
Mailing Address - Country:US
Mailing Address - Phone:336-399-8577
Mailing Address - Fax:
Practice Address - Street 1:7347 ETHANS WAY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8080
Practice Address - Country:US
Practice Address - Phone:336-399-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health