Provider Demographics
NPI:1245641166
Name:GUILETTE, ANGELA NICOLE (MA, LCAS, LCMHC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICOLE
Last Name:GUILETTE
Suffix:
Gender:F
Credentials:MA, LCAS, LCMHC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:NOWISKI
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:597 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4432
Mailing Address - Country:US
Mailing Address - Phone:910-292-6597
Mailing Address - Fax:866-279-1991
Practice Address - Street 1:597 OLIVER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4432
Practice Address - Country:US
Practice Address - Phone:910-292-6597
Practice Address - Fax:866-279-1991
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3361101YA0400X
NC10300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)