Organization Name: | ANGELA MCGOLDRICK, LPC, LLC |
NPI Number: | 1093047136 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANGELA MARIE MCGOLDRICK (OWNER/DIRECTOR) |
Mailing Address: | 125 Akers Farm Rd Ste D Christiansburg |
State: | VA US |
Postal Code: | 240734864 |
Phone Number: | 5403203601 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2010 |
NPI Last Update Date: | 02/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701004405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |