Provider Demographics
NPI:1639975451
Name:FOXWORTH, ANGELA (CERTIFIED COACH)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:FOXWORTH
Suffix:
Gender:
Credentials:CERTIFIED COACH
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:FOXWORTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COACH ANGIEFOX
Mailing Address - Street 1:34 DOLLARD DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-7822
Mailing Address - Country:US
Mailing Address - Phone:803-295-1001
Mailing Address - Fax:
Practice Address - Street 1:34 DOLLARD DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-7822
Practice Address - Country:US
Practice Address - Phone:803-295-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health