Provider Demographics
NPI:1952535080
Name:WOODSON, ANGELINE MARTIN (LPC,NCC)
Entity Type:Individual
Prefix:DR
First Name:ANGELINE
Middle Name:MARTIN
Last Name:WOODSON
Suffix:
Gender:F
Credentials:LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 OAK PARK RD STE B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3027
Mailing Address - Country:US
Mailing Address - Phone:919-272-6932
Mailing Address - Fax:919-729-5045
Practice Address - Street 1:5102 OAK PARK RD STE B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3027
Practice Address - Country:US
Practice Address - Phone:919-272-6932
Practice Address - Fax:919-729-5045
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3914101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health