Provider Demographics
NPI:1295402758
Name:ENGLE, ANGELA ROSE (MA, NCC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ROSE
Last Name:ENGLE
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1197 WADING POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:HUGER
Mailing Address - State:SC
Mailing Address - Zip Code:29450-9813
Mailing Address - Country:US
Mailing Address - Phone:717-875-4584
Mailing Address - Fax:
Practice Address - Street 1:1197 WADING POINT BLVD
Practice Address - Street 2:
Practice Address - City:HUGER
Practice Address - State:SC
Practice Address - Zip Code:29450-9813
Practice Address - Country:US
Practice Address - Phone:717-875-4584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YP2500X
PAPC017020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health