Provider Demographics
NPI:1265070643
Name:WORTH, ANGELA LINDSEY (MS, LMFTA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LINDSEY
Last Name:WORTH
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14203 SALEM RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-2437
Mailing Address - Country:US
Mailing Address - Phone:704-095-5545
Mailing Address - Fax:
Practice Address - Street 1:14203 SALEM RIDGE RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-2437
Practice Address - Country:US
Practice Address - Phone:704-095-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12202A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist