Provider Demographics
NPI:1750554770
Name:COWELL, ANGELA QUINLIVAN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:QUINLIVAN
Last Name:COWELL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 HEDGEPATH TER
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3296
Mailing Address - Country:US
Mailing Address - Phone:336-471-8514
Mailing Address - Fax:
Practice Address - Street 1:890 HEDGEPATH TER
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3296
Practice Address - Country:US
Practice Address - Phone:336-471-8514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0040501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002583Medicaid